39D0906611 CLIA NUMBER - MILLER DONMOYER FAMILY HEALTH CENTER

Laboratory Demographics

CLIA Number: 39D0906611

Facility Name: MILLER DONMOYER FAMILY HEALTH CENTER

Facility Address:
255 WEST SPRUCE STREET
SHAMOKIN, PA
ZIP 17872
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Facility Phone Number: 717 644-5050

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1346541935

Taxonomy: 261QR1300X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	39D0906611
LAB Type	Physician Office
Facility Name	MILLER DONMOYER FAMILY HEALTH CENTER
Street	255 WEST SPRUCE STREET
City	SHAMOKIN
State	PA
ZIP	17872
Phone	717 644-5050
CertificateType	4
CertificateEffectiveDate	10/3/2023
CertificateExpirationDate	10/2/2025
FacilityType	Waiver

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