39D0978835 CLIA NUMBER - COLLEGEVILLE FAMILY PRACTICE

Laboratory Demographics

  • CLIA Code: 39D0978835
  • Facility Name: COLLEGEVILLE FAMILY PRACTICE
  • Facility Address: 555 SECOND AVENUE SUITE 300
    COLLEGEVILLE, PA
    ZIP 19426
  • Facility Phone: 610 454-7750
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: DR. BIRGIT WISWE
  • NPI Number: 1942324330
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 39D0978835
LAB Type Physician Office
Facility Name COLLEGEVILLE FAMILY PRACTICE
Street 555 SECOND AVENUE SUITE 300
City COLLEGEVILLE
State PA
ZIP 19426
Phone 610 454-7750
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/4/2024
Certificate Expiration Date 10/3/2026
Facility Type Physician Office
Lab Director DR. BIRGIT WISWE

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