39D0976970 CLIA NUMBER - LVPG INTERNAL MEDICINE - FOGELSVILLE

Laboratory Demographics

  • CLIA Code: 39D0976970
  • Facility Name: LVPG INTERNAL MEDICINE - FOGELSVILLE
  • Facility Address: 1431 NURSERY ST, SUITE 101A
    FOGELSVILLE, PA
    ZIP 18051
  • Facility Phone: 610 336-8260
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: DR. CLINTON C. HOLUMZER
  • NPI Number: 1417285503
  • Taxonomy: 207R00000X - Internal Medicine

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CLIA Record

Field Name Field Value
CLIA Number 39D0976970
LAB Type Physician Office
Facility Name LVPG INTERNAL MEDICINE - FOGELSVILLE
Street 1431 NURSERY ST, SUITE 101A
City FOGELSVILLE
State PA
ZIP 18051
Phone 610 336-8260
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/4/2025
Certificate Expiration Date 4/3/2027
Facility Type Physician Office
Lab Director DR. CLINTON C. HOLUMZER

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