39D2155122 CLIA NUMBER - WELLSPAN FAMILY MEDICINE - SPRING GROVE

Laboratory Demographics

  • CLIA Code: 39D2155122
  • Facility Name: WELLSPAN FAMILY MEDICINE - SPRING GROVE
  • Facility Address: 430 N MAIN ST, SUITE 4
    SPRING GROVE, PA
    ZIP 17362
  • Facility Phone: 717 851-6500
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: DR. QUINCY O. HARBERGER
  • NPI Number: 1457831638
  • Taxonomy: 207Q00000X - Family Medicine

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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
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/2/2024
Certificate Expiration Date 4/1/2026
Facility Type Physician Office
Lab Director DR. QUINCY O. HARBERGER

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