39D0966801 CLIA NUMBER - BAXTER DREW WELLMON II DO PC

Laboratory Demographics

  • CLIA Code: 39D0966801
  • Facility Name: BAXTER DREW WELLMON II DO PC
  • Facility Address: 93 PROGRESS BLVD
    SHIPPENSBURG, PA
    ZIP 17257
  • Facility Phone: 717 532-3211
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: DR. BAXTER D. WELLMON II DO
  • NPI Number: 1356474456
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 39D0966801
LAB Type Physician Office
Facility Name BAXTER DREW WELLMON II DO PC
Street 93 PROGRESS BLVD
City SHIPPENSBURG
State PA
ZIP 17257
Phone 717 532-3211
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/25/2023
Certificate Expiration Date 10/24/2025
Facility Type Physician Office
Lab Director DR. BAXTER D. WELLMON II DO

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