39D0703013 CLIA NUMBER - MACISAAC FAMILY MEDICINE LLC

Laboratory Demographics

CLIA Number: 39D0703013

Facility Name: MACISAAC FAMILY MEDICINE LLC

Facility Address:
2000 CORPORATE DRIVE, SUITE 100
WEXFORD, PA
ZIP 15090
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Facility Phone Number: 724 940-9190

Facility Type: Physician Office

Certificate Type: Microscopy

NPI Number: 1881615003

Taxonomy: 207Q00000X - Family Medicine
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.

CLIA Record

Field Name	Field Value
CLIA Number	39D0703013
LAB Type	Physician Office
Facility Name	MACISAAC FAMILY MEDICINE LLC
Street	2000 CORPORATE DRIVE, SUITE 100
City	WEXFORD
State	PA
ZIP	15090
Phone	724 940-9190
CertificateType	3
CertificateEffectiveDate	11/14/2022
CertificateExpirationDate	11/13/2024
FacilityType	PPMP

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This page was last updated on: 4/23/2024