39D1078757 CLIA NUMBER - CHILDRENS CMTY PEDIATRICS GREENVILLE

Laboratory Demographics

  • CLIA Code: 39D1078757
  • Facility Name: CHILDRENS CMTY PEDIATRICS GREENVILLE
  • Facility Address: 90 SHENANGO STREET, SUITE #12
    GREENVILLE, PA
    ZIP 16125
  • Facility Phone: 724 589-0290
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: LYNNE A. MCCRILLIS
  • NPI Number: 1558546366
  • Taxonomy: 208000000X - Pediatrics

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CLIA Record

Field Name Field Value
CLIA Number 39D1078757
LAB Type Physician Office
Facility Name CHILDRENS CMTY PEDIATRICS GREENVILLE
Street 90 SHENANGO STREET, SUITE #12
City GREENVILLE
State PA
ZIP 16125
Phone 724 589-0290
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 1/16/2024
Certificate Expiration Date 1/15/2026
Facility Type Physician Office
Lab Director LYNNE A. MCCRILLIS

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