39D0997629 CLIA NUMBER - KENNETH SEBASTIANELLI MD

Laboratory Demographics

  • CLIA Code: 39D0997629
  • Facility Name: KENNETH SEBASTIANELLI MD
  • Facility Address: 532 MAIN STREET, SUITE #1
    MOOSIC, PA
    ZIP 18507
  • Facility Phone: 570 471-3569
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: KENNETH J. SEBASTIANELLI
  • NPI Number: 1679543110
  • Taxonomy: 207R00000X - Internal Medicine

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CLIA Record

Field Name Field Value
CLIA Number 39D0997629
LAB Type Physician Office
Facility Name KENNETH SEBASTIANELLI MD
Street 532 MAIN STREET, SUITE #1
City MOOSIC
State PA
ZIP 18507
Phone 570 471-3569
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/22/2024
Certificate Expiration Date 3/21/2026
Facility Type Physician Office
Lab Director KENNETH J. SEBASTIANELLI

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