39D2047925 CLIA NUMBER - WAYNE PRIMARY CARE

Laboratory Demographics

  • CLIA Code: 39D2047925
  • Facility Name: WAYNE PRIMARY CARE
  • Facility Address: 650 EAST AVE SUITE 210
    ERIE, PA
    ZIP 16503
  • Facility Phone: 814 455-5505
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: DR. LUKE HOMISON
  • NPI Number: 1649676511
  • Taxonomy: 261QF0400X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 39D2047925
LAB Type Physician Office
Facility Name WAYNE PRIMARY CARE
Street 650 EAST AVE SUITE 210
City ERIE
State PA
ZIP 16503
Phone 814 455-5505
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/5/2024
Certificate Expiration Date 10/4/2026
Facility Type Physician Office
Lab Director DR. LUKE HOMISON

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