39D1016761 CLIA NUMBER - LVPG FAMILY MEDICINE - WEST END

Laboratory Demographics

  • CLIA Code: 39D1016761
  • Facility Name: LVPG FAMILY MEDICINE - WEST END
  • Facility Address: 120 BURRUS BOULEVARD SUITE 200
    BRODHEADSVILLE, PA
    ZIP 18322
  • Facility Phone: 570 992-2237
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: CARESS CHRISTIAN MD
  • NPI Number: 1477625879
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 39D1016761
LAB Type Physician Office
Facility Name LVPG FAMILY MEDICINE - WEST END
Street 120 BURRUS BOULEVARD SUITE 200
City BRODHEADSVILLE
State PA
ZIP 18322
Phone 570 992-2237
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 1/12/2025
Certificate Expiration Date 1/11/2027
Facility Type Physician Office
Lab Director CARESS CHRISTIAN MD

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