39D0683375 CLIA NUMBER - LOYALSOCK FAMILY PRACTICE

Laboratory Demographics

  • CLIA Code: 39D0683375
  • Facility Name: LOYALSOCK FAMILY PRACTICE
  • Facility Address: 1205 GRAMPIAN BOULEVARD SUITE 3C
    WILLIAMSPORT, PA
    ZIP 17701
  • Facility Phone: 570 320-7800
  • Facility Type: Physician Office
  • Facility Type: Microscopy
  • Lab Director: DR. MATTHEW J. MEEKER
  • NPI Number: 1801913009
  • Taxonomy: 122300000X - Dentist

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CLIA Record

Field Name Field Value
CLIA Number 39D0683375
LAB Type Physician Office
Facility Name LOYALSOCK FAMILY PRACTICE
Street 1205 GRAMPIAN BOULEVARD SUITE 3C
City WILLIAMSPORT
State PA
ZIP 17701
Phone 570 320-7800
Certificate Type Certificate for Provider-Performed Microscopy Procedures (PPMP)
Certificate Type Description This certificate is issued to a laboratory in which a physician, midlevel practitioner or dentist performs no tests other than the microscopy procedures. This certificate permits the laboratory to also perform waived tests.
Certificate Effective Date 3/14/2025
Certificate Expiration Date 3/13/2027
Facility Type Physician Office
Lab Director DR. MATTHEW J. MEEKER

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