39D0910172 CLIA NUMBER - INDIAN CREEK FOUNDATION

Laboratory Demographics

  • CLIA Code: 39D0910172
  • Facility Name: INDIAN CREEK FOUNDATION
  • Facility Address: 420 COWPATH ROAD
    SOUDERTON, PA
    ZIP 18964
  • Facility Phone: 267 203-1500
  • Facility Type: Home Health Agency
  • Facility Type: Waiver
  • Lab Director: DEAN STOESZ
  • NPI Number: 1023163854
  • Taxonomy: 251S00000X - Community/Behavioral Health

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CLIA Record

Field Name Field Value
CLIA Number 39D0910172
LAB Type Home Health Agency
Facility Name INDIAN CREEK FOUNDATION
Street 420 COWPATH ROAD
City SOUDERTON
State PA
ZIP 18964
Phone 267 203-1500
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/30/2025
Certificate Expiration Date 9/29/2027
Facility Type Home Health Agency
Lab Director DEAN STOESZ

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