39D0684555 CLIA NUMBER - WELLSPAN LABORATORY

Laboratory Demographics

  • CLIA Code: 39D0684555
  • Facility Name: WELLSPAN LABORATORY
  • Facility Address: 23 BEAVER DR SUITE 1
    DU BOIS, PA
    ZIP 15801
  • Facility Phone: 717 334-6204
  • Facility Type: Skilled Nursing Facility/Nursing Facility
  • Facility Type: Waiver
  • Lab Director: DR. THOMAS C. KELLER
  • NPI Number: 1093829582
  • Taxonomy: 314000000X - Skilled Nursing Facility

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CLIA Record

Field Name Field Value
CLIA Number 39D0684555
LAB Type Skilled Nursing Facility/Nursing Facility
Facility Name WELLSPAN LABORATORY
Street 23 BEAVER DR SUITE 1
City DU BOIS
State PA
ZIP 15801
Phone 717 334-6204
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/1/2024
Certificate Expiration Date 8/31/2026
Facility Type Skilled Nursing Facility/Nursing Facility
Lab Director DR. THOMAS C. KELLER

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