39D1107298 CLIA NUMBER - DERIENZO FAMILY PRACTICE

Laboratory Demographics

  • CLIA Code: 39D1107298
  • Facility Name: DERIENZO FAMILY PRACTICE
  • Facility Address: 17 ARENTZEN BLVD SUITE 101
    CHARLEROI, PA
    ZIP 15022
  • Facility Phone: 724 483-3581
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: DR. UMBERTO A. DERIENZO
  • NPI Number: 1720050289
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 39D1107298
LAB Type Physician Office
Facility Name DERIENZO FAMILY PRACTICE
Street 17 ARENTZEN BLVD SUITE 101
City CHARLEROI
State PA
ZIP 15022
Phone 724 483-3581
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 11/2/2023
Certificate Expiration Date 11/1/2025
Facility Type Physician Office
Lab Director DR. UMBERTO A. DERIENZO

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