39D0932374 CLIA NUMBER - SUSQUEHANNA FAMILY HEALTH CLINIC

Laboratory Demographics

  • CLIA Code: 39D0932374
  • Facility Name: SUSQUEHANNA FAMILY HEALTH CLINIC
  • Facility Address: 401 BROAD AVENUE
    SUSQUEHANNA, PA
    ZIP 18847
  • Facility Phone: 570 853-3995
  • Facility Type: Physician Office
  • Facility Type: Microscopy
  • Lab Director: DR. WARREN S. DEWITT
  • NPI Number: 1023044393
  • Taxonomy: 251300000X - Local Education Agency (LEA)

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CLIA Record

Field Name Field Value
CLIA Number 39D0932374
LAB Type Physician Office
Facility Name SUSQUEHANNA FAMILY HEALTH CLINIC
Street 401 BROAD AVENUE
City SUSQUEHANNA
State PA
ZIP 18847
Phone 570 853-3995
Certificate Type Certificate for Provider-Performed Microscopy Procedures (PPMP)
Certificate Type Description This certificate is issued to a laboratory in which a physician, midlevel practitioner or dentist performs no tests other than the microscopy procedures. This certificate permits the laboratory to also perform waived tests.
Certificate Effective Date 8/20/2025
Certificate Expiration Date 8/19/2027
Facility Type Physician Office
Lab Director DR. WARREN S. DEWITT

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