39D2047292 CLIA NUMBER - WESLEY VILLAGE

Laboratory Demographics

  • CLIA Code: 39D2047292
  • Facility Name: WESLEY VILLAGE
  • Facility Address: 211-215 ROBERTS ROAD
    PITTSTON, PA
    ZIP 18640
  • Facility Phone: 570 655-2891
  • Facility Type: Other - PERSONAL CARE FACILITY
  • Facility Type: Waiver
  • Lab Director: DR. JAMES A. TRICARICO
  • NPI Number: 1992733984
  • Taxonomy: 314000000X - Skilled Nursing Facility

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CLIA Record

Field Name Field Value
CLIA Number 39D2047292
LAB Type Other - PERSONAL CARE FACILITY
Facility Name WESLEY VILLAGE
Street 211-215 ROBERTS ROAD
City PITTSTON
State PA
ZIP 18640
Phone 570 655-2891
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/20/2024
Certificate Expiration Date 9/19/2026
Facility Type Other - PERSONAL CARE FACILITY
Lab Director DR. JAMES A. TRICARICO

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