39D2134671 CLIA NUMBER - CENCLEAR

Laboratory Demographics

CLIA Number: 39D2134671

Facility Name: CENCLEAR

Facility Address:
627 WOOD STREET
CLARION, PA
ZIP 16214
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Facility Phone Number: 814 938-6340

Facility Type: Community Clinic

Certificate Type: Waiver

NPI Number: 1164952677

Taxonomy: 261QC1500X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	39D2134671
LAB Type	Community Clinic
Facility Name	CENCLEAR
Street	627 WOOD STREET
City	CLARION
State	PA
ZIP	16214
Phone	814 938-6340
CertificateType	4
CertificateEffectiveDate	8/8/2023
CertificateExpirationDate	8/7/2025
FacilityType	Waiver

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