39D2046237 CLIA NUMBER - LVPG FAM MED - MACUNGIE

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Laboratory Demographics

CLIA Number: 39D2046237

Facility Name: LVPG FAM MED - MACUNGIE

Facility Address:
3371 PA ROUTE 100 SUITE 300
MACUNGIE, PA
ZIP 18062
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Facility Phone Number: 610 967-2772

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1124379953

Taxonomy: 207Q00000X - Family Medicine
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.

CLIA Record

Field Name	Field Value
CLIA Number	39D2046237
LAB Type	Physician Office
Facility Name	LVPG FAM MED - MACUNGIE
Street	3371 PA ROUTE 100 SUITE 300
City	MACUNGIE
State	PA
ZIP	18062
Phone	610 967-2772
CertificateType	4
CertificateEffectiveDate	10/1/2023
CertificateExpirationDate	9/30/2025
FacilityType	Waiver

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This page was last updated on: 4/23/2024