39D0996912 CLIA NUMBER - PDI EBENSBURG

Laboratory Demographics

  • CLIA Code: 39D0996912
  • Facility Name: PDI EBENSBURG
  • Facility Address: 429 MANOR DRIVE, SUITE 650
    EBENSBURG, PA
    ZIP 15931
  • Facility Phone: 814 472-2642
  • Facility Type: End Stage Renal Disease Dialysis Facility
  • Facility Type: Waiver
  • Lab Director: DR. FAINA GUREVICH
  • NPI Number: 1417919200
  • Taxonomy: 261QE0700X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 39D0996912
LAB Type End Stage Renal Disease Dialysis Facility
Facility Name PDI EBENSBURG
Street 429 MANOR DRIVE, SUITE 650
City EBENSBURG
State PA
ZIP 15931
Phone 814 472-2642
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/1/2024
Certificate Expiration Date 2/28/2026
Facility Type End Stage Renal Disease Dialysis Facility
Lab Director DR. FAINA GUREVICH

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