39D1076088 CLIA NUMBER - EDWARD R LEAHY JR CTR CLIN

Laboratory Demographics

  • CLIA Code: 39D1076088
  • Facility Name: EDWARD R LEAHY JR CTR CLIN
  • Facility Address: 237 JEFFERSON AVENUE
    SCRANTON, PA
    ZIP 18503
  • Facility Phone: 570 941-6112
  • Facility Type: Community Clinic
  • Facility Type: Waiver
  • Lab Director: DR. SUSAN R. RUSSELL
  • NPI Number: 1124184668
  • Taxonomy: 2084P0800X - Psychiatry & Neurology

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 39D1076088
LAB Type Community Clinic
Facility Name EDWARD R LEAHY JR CTR CLIN
Street 237 JEFFERSON AVENUE
City SCRANTON
State PA
ZIP 18503
Phone 570 941-6112
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 2/3/2025
Certificate Expiration Date 2/2/2027
Facility Type Community Clinic
Lab Director DR. SUSAN R. RUSSELL

Download Record

Download this CLIA record record in Text format: Export

Download this CLIA record record in Excel (CSV) format: Export

Download this CLIA record record in XML format: Export

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