39D0951083 CLIA NUMBER - JACKSONVILLE FAMILY MEDICINE

Laboratory Demographics

  • CLIA Code: 39D0951083
  • Facility Name: JACKSONVILLE FAMILY MEDICINE
  • Facility Address: 29 SALTSBURG ROAD
    CLARKSBURG, PA
    ZIP 15725
  • Facility Phone: 724 726-0300
  • Facility Type: Physician Office
  • Facility Type: Microscopy
  • Lab Director: DR. HANEY N. WAHBA
  • NPI Number: 1730386467
  • Taxonomy: 261QF0400X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 39D0951083
LAB Type Physician Office
Facility Name JACKSONVILLE FAMILY MEDICINE
Street 29 SALTSBURG ROAD
City CLARKSBURG
State PA
ZIP 15725
Phone 724 726-0300
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 5/20/2025
Certificate Expiration Date 5/19/2027
Facility Type Physician Office
Lab Director DR. HANEY N. WAHBA

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