39D0947661 CLIA NUMBER - CHILDRENS COMMUNITY PEDIATRICS-BLAIRSVILLE

Laboratory Demographics

  • CLIA Code: 39D0947661
  • Facility Name: CHILDRENS COMMUNITY PEDIATRICS-BLAIRSVILLE
  • Facility Address: 56 CLUB LANE SUITE 201
    BLAIRSVILLE, PA
    ZIP 15717
  • Facility Phone: 724 459-6560
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: DWAYNE T. SHUHART MD
  • NPI Number: 1255349668
  • Taxonomy: 208000000X - Pediatrics

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CLIA Record

Field Name Field Value
CLIA Number 39D0947661
LAB Type Physician Office
Facility Name CHILDRENS COMMUNITY PEDIATRICS-BLAIRSVILLE
Street 56 CLUB LANE SUITE 201
City BLAIRSVILLE
State PA
ZIP 15717
Phone 724 459-6560
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 6/29/2023
Certificate Expiration Date 6/28/2025
Facility Type Physician Office
Lab Director DWAYNE T. SHUHART MD

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This page was last updated on: 6/4/2025