39D0935566 CLIA NUMBER - RUSSELL MILLER MD FAMILY PRACTICE PC

Laboratory Demographics

  • CLIA Code: 39D0935566
  • Facility Name: RUSSELL MILLER MD FAMILY PRACTICE PC
  • Facility Address: 121 BEECH AVENUE
    PATTON, PA
    ZIP 16668
  • Facility Phone: 814 674-5225
  • Facility Type: Physician Office
  • Facility Type: Microscopy
  • Lab Director: RUSSELL P. MILLER MD
  • NPI Number: 1174522270
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 39D0935566
LAB Type Physician Office
Facility Name RUSSELL MILLER MD FAMILY PRACTICE PC
Street 121 BEECH AVENUE
City PATTON
State PA
ZIP 16668
Phone 814 674-5225
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 11/3/2023
Certificate Expiration Date 11/2/2025
Facility Type Physician Office
Lab Director RUSSELL P. MILLER MD

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