39D0690356 CLIA NUMBER - UPMC WELLSBORO OFFICE OF INTERNAL MEDICINE

Laboratory Demographics

  • CLIA Code: 39D0690356
  • Facility Name: UPMC WELLSBORO OFFICE OF INTERNAL MEDICINE
  • Facility Address: 103 WEST AVE SUITE 203
    WELLSBORO, PA
    ZIP 16901
  • Facility Phone: 570 724-3744
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: DR. REBECCA A. RICKARD
  • NPI Number: 1275090433
  • Taxonomy: 207R00000X - Internal Medicine

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CLIA Record

Field Name Field Value
CLIA Number 39D0690356
LAB Type Physician Office
Facility Name UPMC WELLSBORO OFFICE OF INTERNAL MEDICINE
Street 103 WEST AVE SUITE 203
City WELLSBORO
State PA
ZIP 16901
Phone 570 724-3744
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 Physician Office
Lab Director DR. REBECCA A. RICKARD

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