39D1061488 CLIA NUMBER - CENTRE ORAL & FACIAL SURGERY PC

Laboratory Demographics

  • CLIA Code: 39D1061488
  • Facility Name: CENTRE ORAL & FACIAL SURGERY PC
  • Facility Address: 474 WINDMERE DRIVE SUITE 202
    STATE COLLEGE, PA
    ZIP 16801
  • Facility Phone: 814 235-7700
  • Facility Type: Other
  • Facility Type: Waiver
  • Lab Director: GREG F. KEWITT MD
  • NPI Number: 1386692184
  • Taxonomy: 1223S0112X - Dentist

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CLIA Record

Field Name Field Value
CLIA Number 39D1061488
LAB Type Other
Facility Name CENTRE ORAL & FACIAL SURGERY PC
Street 474 WINDMERE DRIVE SUITE 202
City STATE COLLEGE
State PA
ZIP 16801
Phone 814 235-7700
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 11/20/2024
Certificate Expiration Date 11/19/2026
Facility Type Other
Lab Director GREG F. KEWITT MD

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