39D1059365 CLIA NUMBER - THOMAS P SAXTON MEDICAL PAVILLION

Laboratory Demographics

  • CLIA Code: 39D1059365
  • Facility Name: THOMAS P SAXTON MEDICAL PAVILLION
  • Facility Address: 468 NORTHAMPTON STREET
    EDWARDSVILLE, PA
    ZIP 18704
  • Facility Phone: 570 552-4665
  • Facility Type: Other
  • Facility Type: Waiver
  • Lab Director: DR. JOAN FORGETTA
  • NPI Number: 1679661219
  • Taxonomy: 213E00000X - Podiatrist

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CLIA Record

Field Name Field Value
CLIA Number 39D1059365
LAB Type Other
Facility Name THOMAS P SAXTON MEDICAL PAVILLION
Street 468 NORTHAMPTON STREET
City EDWARDSVILLE
State PA
ZIP 18704
Phone 570 552-4665
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/28/2024
Certificate Expiration Date 9/27/2026
Facility Type Other
Lab Director DR. JOAN FORGETTA

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