39D2142447 CLIA NUMBER - NORTHEASTERN REHABILITATION ASSOC

Laboratory Demographics

  • CLIA Code: 39D2142447
  • Facility Name: NORTHEASTERN REHABILITATION ASSOC
  • Facility Address: 150 MUNDY ST
    WILKES BARRE, PA
    ZIP 18702
  • Facility Phone: 570 824-0930
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: DR. CHRISTOPHER J. CONNOR
  • NPI Number: 1003074600
  • Taxonomy: 207QG0300X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 39D2142447
LAB Type Physician Office
Facility Name NORTHEASTERN REHABILITATION ASSOC
Street 150 MUNDY ST
City WILKES BARRE
State PA
ZIP 18702
Phone 570 824-0930
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 1/11/2024
Certificate Expiration Date 1/10/2026
Facility Type Physician Office
Lab Director DR. CHRISTOPHER J. CONNOR

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