39D2104766 CLIA NUMBER - PENN HOSPICE, INC

Laboratory Demographics

  • CLIA Code: 39D2104766
  • Facility Name: PENN HOSPICE, INC
  • Facility Address: 313 WEST HIGH STREET SUITE 210
    EBENSBURG, PA
    ZIP 15931
  • Facility Phone: 814 846-4160
  • Facility Type: Hospice
  • Facility Type: Waiver
  • Lab Director: DR. VICTOR NOVAK MD
  • NPI Number: 1427426709
  • Taxonomy: 251G00000X - Hospice Care, Community Based

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CLIA Record

Field Name Field Value
CLIA Number 39D2104766
LAB Type Hospice
Facility Name PENN HOSPICE, INC
Street 313 WEST HIGH STREET SUITE 210
City EBENSBURG
State PA
ZIP 15931
Phone 814 846-4160
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 11/12/2023
Certificate Expiration Date 11/11/2025
Facility Type Hospice
Lab Director DR. VICTOR NOVAK MD

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