39D0876060 CLIA NUMBER - PEDIATRIC CARE CENTER

Laboratory Demographics

  • CLIA Code: 39D0876060
  • Facility Name: PEDIATRIC CARE CENTER
  • Facility Address: BOX 268 ROUTE 403 SOUTH 100 NEAL AVENUE
    MARION CENTER, PA
    ZIP 15759
  • Facility Phone: 724 397-2326
  • Facility Type: Community Clinic
  • Facility Type: Waiver
  • Lab Director: JABIR RIZWAN MD
  • NPI Number: 1972691103
  • Taxonomy: 2080A0000X - Pediatrics

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CLIA Record

Field Name Field Value
CLIA Number 39D0876060
LAB Type Community Clinic
Facility Name PEDIATRIC CARE CENTER
Street BOX 268 ROUTE 403 SOUTH 100 NEAL AVENUE
City MARION CENTER
State PA
ZIP 15759
Phone 724 397-2326
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 12/20/2024
Certificate Expiration Date 12/19/2026
Facility Type Community Clinic
Lab Director JABIR RIZWAN MD

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