39D2155122 CLIA NUMBER - WELLSPAN FAMILY MEDICINE - SPRING GROVE

Laboratory Demographics

CLIA Number: 39D2155122

Facility Name: WELLSPAN FAMILY MEDICINE - SPRING GROVE

Facility Address:
430 N MAIN ST, SUITE 4
SPRING GROVE, PA
ZIP 17362
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Facility Phone Number: 717 851-6500

Facility Type: Physician Office

Certificate Type: Microscopy

NPI Number: 1457831638

Taxonomy: 207Q00000X - Family Medicine
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.

CLIA Record

Field Name	Field Value
CLIA Number	39D2155122
LAB Type	Physician Office
Facility Name	WELLSPAN FAMILY MEDICINE - SPRING GROVE
Street	430 N MAIN ST, SUITE 4
City	SPRING GROVE
State	PA
ZIP	17362
Phone	717 851-6500
CertificateType	3
CertificateEffectiveDate	9/25/2022
CertificateExpirationDate	9/24/2024
FacilityType	PPMP

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