39D2076397 CLIA NUMBER - SENIOR LIFE LEHIGH VALLEY

Laboratory Demographics

CLIA Code: 39D2076397
Facility Name: SENIOR LIFE LEHIGH VALLEY
Facility Address: 3365 HIGH POINT BLVD
BETHLEHEM, PA
ZIP 18017
Facility Phone: 610 954-5433
Facility Type: Other - ADULT DAY CARE FACILITY
Facility Type: Waiver
Lab Director: DR. BRENT M. NICKISCHER
NPI Number: 1356789358
Taxonomy: 251T00000X - Program of All-Inclusive Care for the Elderly (PACE) Provider Organization

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CLIA Record

Field Name	Field Value
CLIA Number	39D2076397
LAB Type	Other - ADULT DAY CARE FACILITY
Facility Name	SENIOR LIFE LEHIGH VALLEY
Street	3365 HIGH POINT BLVD
City	BETHLEHEM
State	PA
ZIP	18017
Phone	610 954-5433
Certificate Type	Certificate of Waiver
Certificate Type Description	This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date	4/17/2024
Certificate Expiration Date	4/16/2026
Facility Type	Other - ADULT DAY CARE FACILITY
Lab Director	DR. BRENT M. NICKISCHER

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