39D2024630 CLIA NUMBER - UNION COMMUNITY CARE AT CHURCH STREET

Laboratory Demographics

CLIA Code: 39D2024630
Facility Name: UNION COMMUNITY CARE AT CHURCH STREET
Facility Address: 920 CHURCH STREET
LEBANON, PA
ZIP 17046
Facility Phone: 717 945-1568
Facility Type: Federally Qualified Health Center
Facility Type: Microscopy
Lab Director: DR. MATTHEW A. WEITZEL
NPI Number: 1841785607
Taxonomy: 261QF0400X - Clinic/Center

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CLIA Record

Field Name	Field Value
CLIA Number	39D2024630
LAB Type	Federally Qualified Health Center
Facility Name	UNION COMMUNITY CARE AT CHURCH STREET
Street	920 CHURCH STREET
City	LEBANON
State	PA
ZIP	17046
Phone	717 945-1568
Certificate Type	Certificate for Provider-Performed Microscopy Procedures (PPMP)
Certificate Type Description	This certificate is issued to a laboratory in which a physician, midlevel practitioner or dentist performs no tests other than the microscopy procedures. This certificate permits the laboratory to also perform waived tests.
Certificate Effective Date	12/10/2023
Certificate Expiration Date	12/9/2025
Facility Type	Federally Qualified Health Center
Lab Director	DR. MATTHEW A. WEITZEL

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