39D0948631 CLIA NUMBER - WELLSPAN OB/GYN STONEBRIDGE

Laboratory Demographics

  • CLIA Code: 39D0948631
  • Facility Name: WELLSPAN OB/GYN STONEBRIDGE
  • Facility Address: 13515 WOLFE ROAD
    NEW FREEDOM, PA
    ZIP 17349
  • Facility Phone: 717 812-2540
  • Facility Type: Physician Office
  • Facility Type: Microscopy
  • Lab Director: DR. DEREK LIANG
  • NPI Number: 1629146709
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 39D0948631
LAB Type Physician Office
Facility Name WELLSPAN OB/GYN STONEBRIDGE
Street 13515 WOLFE ROAD
City NEW FREEDOM
State PA
ZIP 17349
Phone 717 812-2540
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 7/16/2024
Certificate Expiration Date 7/15/2026
Facility Type Physician Office
Lab Director DR. DEREK LIANG

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