39D2041362 CLIA NUMBER - INTEGRATED MEDICAL GROUP, PC-SWAIN LAZUR

Laboratory Demographics

  • CLIA Code: 39D2041362
  • Facility Name: INTEGRATED MEDICAL GROUP, PC-SWAIN LAZUR
  • Facility Address: 100 SCHUYLKILL MEDICAL PLAZA SUITE 202
    POTTSVILLE, PA
    ZIP 17901
  • Facility Phone: 570 286-7417
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: DR. DIANNA D. LAZUR DO
  • NPI Number: 1639793912
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 39D2041362
LAB Type Physician Office
Facility Name INTEGRATED MEDICAL GROUP, PC-SWAIN LAZUR
Street 100 SCHUYLKILL MEDICAL PLAZA SUITE 202
City POTTSVILLE
State PA
ZIP 17901
Phone 570 286-7417
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 5/22/2024
Certificate Expiration Date 5/21/2026
Facility Type Physician Office
Lab Director DR. DIANNA D. LAZUR DO

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