39D2057288 CLIA NUMBER - GEISINGER BLOOMSBURG GLENN AVE

Laboratory Demographics

  • CLIA Code: 39D2057288
  • Facility Name: GEISINGER BLOOMSBURG GLENN AVE
  • Facility Address: 410 GLENN AVE
    BLOOMSBURG, PA
    ZIP 17815
  • Facility Phone: 570 387-2011
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: DR. TIMOTHY R. HOGAN
  • NPI Number: 1780295733
  • Taxonomy: 2084N0400X - Psychiatry & Neurology

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 39D2057288
LAB Type Physician Office
Facility Name GEISINGER BLOOMSBURG GLENN AVE
Street 410 GLENN AVE
City BLOOMSBURG
State PA
ZIP 17815
Phone 570 387-2011
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/14/2024
Certificate Expiration Date 3/13/2026
Facility Type Physician Office
Lab Director DR. TIMOTHY R. HOGAN

Download Record

Download this CLIA record record in Text format: Export

Download this CLIA record record in Excel (CSV) format: Export

Download this CLIA record record in XML format: Export

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