39D0191976 CLIA NUMBER - PRIME MED PC

Laboratory Demographics

  • CLIA Code: 39D0191976
  • Facility Name: PRIME MED PC
  • Facility Address: 231 NORTHERN BOULEVARD SUITE 3
    CLARKS SUMMIT, PA
    ZIP 18411
  • Facility Phone: 717 348-6144
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: DOMINIC RUGGIERO
  • NPI Number: 1023243391
  • Taxonomy: 291U00000X - Clinical Medical Laboratory

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CLIA Record

Field Name Field Value
CLIA Number 39D0191976
LAB Type Physician Office
Facility Name PRIME MED PC
Street 231 NORTHERN BOULEVARD SUITE 3
City CLARKS SUMMIT
State PA
ZIP 18411
Phone 717 348-6144
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 6/7/2025
Certificate Expiration Date 6/6/2027
Facility Type Physician Office
Lab Director DOMINIC RUGGIERO

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This page was last updated on: 9/29/2025