39D1006526 CLIA NUMBER - WELLSPAN FAMILY MED-VALLEY GREEN WELLSPAN HEALTH GROUP

Laboratory Demographics

  • CLIA Code: 39D1006526
  • Facility Name: WELLSPAN FAMILY MED-VALLEY GREEN WELLSPAN HEALTH GROUP
  • Facility Address: 1790 OLD TRAIL ROAD
    ETTERS, PA
    ZIP 17319
  • Facility Phone: 717 938-6588
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: DR. SHANE LOHSS
  • NPI Number: 1760550883
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 39D1006526
LAB Type Physician Office
Facility Name WELLSPAN FAMILY MED-VALLEY GREEN WELLSPAN HEALTH GROUP
Street 1790 OLD TRAIL ROAD
City ETTERS
State PA
ZIP 17319
Phone 717 938-6588
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/1/2025
Certificate Expiration Date 3/31/2027
Facility Type Physician Office
Lab Director DR. SHANE LOHSS

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