39D0879550 CLIA NUMBER - GEORGE JUNIOR REPUBLIC INFIRMARY

Laboratory Demographics

  • CLIA Code: 39D0879550
  • Facility Name: GEORGE JUNIOR REPUBLIC INFIRMARY
  • Facility Address: 233 GEORGE JUNIOR RD
    GROVE CITY, PA
    ZIP 16127
  • Facility Phone: 724 458-9330
  • Facility Type: School/Student Health Service
  • Facility Type: Waiver
  • Lab Director: DR. MARK DEMIDOVICH
  • NPI Number: 1831550409
  • Taxonomy: 323P00000X - Psychiatric Residential Treatment Facility

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CLIA Record

Field Name Field Value
CLIA Number 39D0879550
LAB Type School/Student Health Service
Facility Name GEORGE JUNIOR REPUBLIC INFIRMARY
Street 233 GEORGE JUNIOR RD
City GROVE CITY
State PA
ZIP 16127
Phone 724 458-9330
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 11/22/2023
Certificate Expiration Date 11/21/2025
Facility Type School/Student Health Service
Lab Director DR. MARK DEMIDOVICH

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