39D0690964 CLIA NUMBER - UPMC PRIMARY CARE

Laboratory Demographics

  • CLIA Code: 39D0690964
  • Facility Name: UPMC PRIMARY CARE
  • Facility Address: 175 PINE STREET 2ND FLOOR
    WILLIAMSPORT, PA
    ZIP 17701
  • Facility Phone: 570 326-2447
  • Facility Type: Practitioner Other
  • Facility Type: Microscopy
  • Lab Director: DR. MICHELLE L. CAVANAUGH
  • NPI Number: 1013918697
  • Taxonomy: 208000000X - Pediatrics

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CLIA Record

Field Name Field Value
CLIA Number 39D0690964
LAB Type Practitioner Other
Facility Name UPMC PRIMARY CARE
Street 175 PINE STREET 2ND FLOOR
City WILLIAMSPORT
State PA
ZIP 17701
Phone 570 326-2447
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 11/16/2023
Certificate Expiration Date 11/15/2025
Facility Type Practitioner Other
Lab Director DR. MICHELLE L. CAVANAUGH

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