39D2021867 CLIA NUMBER - LVPG FAM MED - MOSELEM SPRINGS

Laboratory Demographics

  • CLIA Code: 39D2021867
  • Facility Name: LVPG FAM MED - MOSELEM SPRINGS
  • Facility Address: 14351 KUTZTOWN ROAD
    FLEETWOOD, PA
    ZIP 19522
  • Facility Phone: 610 944-8800
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: MR. TORY J. CLUGSTON
  • NPI Number: 1164866638
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 39D2021867
LAB Type Physician Office
Facility Name LVPG FAM MED - MOSELEM SPRINGS
Street 14351 KUTZTOWN ROAD
City FLEETWOOD
State PA
ZIP 19522
Phone 610 944-8800
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/24/2025
Certificate Expiration Date 9/23/2027
Facility Type Physician Office
Lab Director MR. TORY J. CLUGSTON

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