39D0901471 CLIA NUMBER - NORTHERN GASTROENTEROLOGY-UPMC

Laboratory Demographics

  • CLIA Code: 39D0901471
  • Facility Name: NORTHERN GASTROENTEROLOGY-UPMC
  • Facility Address: 5500 BROOKTREE ROAD, SUITE 201
    WEXFORD, PA
    ZIP 15090
  • Facility Phone: 724 933-1420
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: MICHAEL L. MLECKO
  • NPI Number: 1730170713
  • Taxonomy: 207RG0100X - Internal Medicine

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 39D0901471
LAB Type Physician Office
Facility Name NORTHERN GASTROENTEROLOGY-UPMC
Street 5500 BROOKTREE ROAD, SUITE 201
City WEXFORD
State PA
ZIP 15090
Phone 724 933-1420
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 5/30/2025
Certificate Expiration Date 5/29/2027
Facility Type Physician Office
Lab Director MICHAEL L. MLECKO

Download Record

Download this CLIA record record in Text format: Export

Download this CLIA record record in Excel (CSV) format: Export

Download this CLIA record record in XML format: Export

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