39D0958100 CLIA NUMBER - ANTHONY F SHEDLOCK DO

Laboratory Demographics

CLIA Number: 39D0958100

Facility Name: ANTHONY F SHEDLOCK DO

Facility Address:
612 CLARA STREET
HOUTZDALE, PA
ZIP 16651
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Facility Phone Number: 814 378-9716

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1114038387

Taxonomy: 207Q00000X - Family Medicine
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.

CLIA Record

Field Name	Field Value
CLIA Number	39D0958100
LAB Type	Physician Office
Facility Name	ANTHONY F SHEDLOCK DO
Street	612 CLARA STREET
City	HOUTZDALE
State	PA
ZIP	16651
Phone	814 378-9716
CertificateType	4
CertificateEffectiveDate	3/11/2023
CertificateExpirationDate	3/10/2025
FacilityType	Waiver

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This page was last updated on: 4/23/2024