39D0947096 CLIA NUMBER - MATTHEW N KLAIN MD LABORATORY

Laboratory Demographics

CLIA Number: 39D0947096

Facility Name: MATTHEW N KLAIN MD LABORATORY

Facility Address:
1265 WAYNE AVENUE, SUITE 102
INDIANA, PA
ZIP 15701
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Facility Phone Number: 724 349-4411

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1760932982

Taxonomy: 101Y00000X - Counselor
A provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master's degree and clinical experience and supervision for licensure or certification.

CLIA Record

Field Name	Field Value
CLIA Number	39D0947096
LAB Type	Physician Office
Facility Name	MATTHEW N KLAIN MD LABORATORY
Street	1265 WAYNE AVENUE, SUITE 102
City	INDIANA
State	PA
ZIP	15701
Phone	724 349-4411
CertificateType	4
CertificateEffectiveDate	6/9/2022
CertificateExpirationDate	6/8/2024
FacilityType	Waiver

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