39D1083644 CLIA NUMBER - MICHAEL A MARZANO VA OUTPATIENT CLINIC

Laboratory Demographics

  • CLIA Code: 39D1083644
  • Facility Name: MICHAEL A MARZANO VA OUTPATIENT CLINIC
  • Facility Address: 295 KERRWOOD DR SUITE 110
    HERMITAGE, PA
    ZIP 16148
  • Facility Phone: 724 346-1569
  • Facility Type: Ambulatory Surgery Center
  • Facility Type: Accreditation
  • Lab Director: SCOTT M. KULICH
  • NPI Number: 1487693271
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 39D1083644
LAB Type Ambulatory Surgery Center
Facility Name MICHAEL A MARZANO VA OUTPATIENT CLINIC
Street 295 KERRWOOD DR SUITE 110
City HERMITAGE
State PA
ZIP 16148
Phone 724 346-1569
Certificate Type Certificate of Accreditation
Certificate Type Description This is a certificate that is issued to a laboratory on the basis of the laboratory's accreditation by an accreditation organization approved by CMS.
Certificate Effective Date 5/7/2008
Certificate Expiration Date 5/22/2026
Facility Type Ambulatory Surgery Center
Lab Director SCOTT M. KULICH

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