39D0948576 CLIA NUMBER - PRIME MED PC BRUNDAGE & WILLIAMS

Laboratory Demographics

  • CLIA Code: 39D0948576
  • Facility Name: PRIME MED PC BRUNDAGE & WILLIAMS
  • Facility Address: 320 KEYSTONE AVENUE
    PECKVILLE, PA
    ZIP 18452
  • Facility Phone: 570 489-0871
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: KEVIN G. WILLIAMS MD
  • NPI Number: 1528475100
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 39D0948576
LAB Type Physician Office
Facility Name PRIME MED PC BRUNDAGE & WILLIAMS
Street 320 KEYSTONE AVENUE
City PECKVILLE
State PA
ZIP 18452
Phone 570 489-0871
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 7/14/2024
Certificate Expiration Date 7/13/2026
Facility Type Physician Office
Lab Director KEVIN G. WILLIAMS MD

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