39D2119068 CLIA NUMBER - LVPG FAM MED - BANGOR

Laboratory Demographics

  • CLIA Code: 39D2119068
  • Facility Name: LVPG FAM MED - BANGOR
  • Facility Address: 1337 BLUE VALLEY DR SUITE 7
    PEN ARGYL, PA
    ZIP 18072
  • Facility Phone: 610 654-1270
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: DR. PHILIP J. CINELLI
  • NPI Number: 1295282226
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 39D2119068
LAB Type Physician Office
Facility Name LVPG FAM MED - BANGOR
Street 1337 BLUE VALLEY DR SUITE 7
City PEN ARGYL
State PA
ZIP 18072
Phone 610 654-1270
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/20/2024
Certificate Expiration Date 9/19/2026
Facility Type Physician Office
Lab Director DR. PHILIP J. CINELLI

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