39D0955077 CLIA NUMBER - MEMORIAL FAMILY MEDICINE AT MANCHESTER

Laboratory Demographics

  • CLIA Code: 39D0955077
  • Facility Name: MEMORIAL FAMILY MEDICINE AT MANCHESTER
  • Facility Address: 4314 NORTH GEORGE STREET
    MANCHESTER, PA
    ZIP 17345
  • Facility Phone: 717 266-0252
  • Facility Type: Physician Office
  • Facility Type: Microscopy
  • Lab Director: DR. ROGER L. PALISOC
  • NPI Number: 1104291707
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 39D0955077
LAB Type Physician Office
Facility Name MEMORIAL FAMILY MEDICINE AT MANCHESTER
Street 4314 NORTH GEORGE STREET
City MANCHESTER
State PA
ZIP 17345
Phone 717 266-0252
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 12/17/2024
Certificate Expiration Date 12/16/2026
Facility Type Physician Office
Lab Director DR. ROGER L. PALISOC

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