39D2090239 CLIA NUMBER - LVPG HEMATOLOGY ONCOLOGY-CARBON

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Laboratory Demographics

CLIA Number: 39D2090239

Facility Name: LVPG HEMATOLOGY ONCOLOGY-CARBON

Facility Address:
2226 BLAKESLEE BLVD DRIVE E, SUITE 200
LEHIGHTON, PA
ZIP 18235
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Facility Phone Number: 610 402-7880

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1740462134

Taxonomy: 207RH0003X - Internal Medicine
An internist doctor of osteopathy that specializes in the treatment of the combination of hematology and oncology disorders. A doctor of osteopathy that is board eligible/certified by the American Osteopathic Board of Internal Medicine WAS able to obtain a Certificate of Special Qualifications in the field of Hematology and Oncology. The Certificate is NO longer offered.

CLIA Record

Field Name	Field Value
CLIA Number	39D2090239
LAB Type	Physician Office
Facility Name	LVPG HEMATOLOGY ONCOLOGY-CARBON
Street	2226 BLAKESLEE BLVD DRIVE E, SUITE 200
City	LEHIGHTON
State	PA
ZIP	18235
Phone	610 402-7880
CertificateType	4
CertificateEffectiveDate	1/20/2023
CertificateExpirationDate	1/19/2025
FacilityType	Waiver

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