39D1019493 CLIA NUMBER - CENTERVILLE CLINIC CONNELLSVILLE OFFICE

Laboratory Demographics

  • CLIA Code: 39D1019493
  • Facility Name: CENTERVILLE CLINIC CONNELLSVILLE OFFICE
  • Facility Address: 601 SOUTH ARCH STREET
    CONNELLSVILLE, PA
    ZIP 15425
  • Facility Phone: (724) 626-2630
  • Facility Type: Federally Qualified Health Center
  • Facility Type: Waiver
  • Lab Director: DR. THOMAS G. WITTMAN
  • NPI Number: 1790951655
  • Taxonomy: 174400000X - Specialist

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CLIA Record

Field Name Field Value
CLIA Number 39D1019493
LAB Type Federally Qualified Health Center
Facility Name CENTERVILLE CLINIC CONNELLSVILLE OFFICE
Street 601 SOUTH ARCH STREET
City CONNELLSVILLE
State PA
ZIP 15425
Phone 7246262630
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 11/20/2025
Certificate Expiration Date 11/19/2027
Facility Type Federally Qualified Health Center
Lab Director DR. THOMAS G. WITTMAN

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This page was last updated on: 5/18/2026