39D2177979 CLIA NUMBER - ST LUKE'S DERMATOLOGY

Laboratory Demographics

  • CLIA Code: 39D2177979
  • Facility Name: ST LUKE'S DERMATOLOGY
  • Facility Address: 487 E MOORESTOWN RD, SUITE 104
    WIND GAP, PA
    ZIP 18091
  • Facility Phone: 484 526-7349
  • Facility Type: Physician Office
  • Facility Type: Microscopy
  • Lab Director: ANDREW C. KRAKOWSKI
  • NPI Number: 1811214950
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 39D2177979
LAB Type Physician Office
Facility Name ST LUKE'S DERMATOLOGY
Street 487 E MOORESTOWN RD, SUITE 104
City WIND GAP
State PA
ZIP 18091
Phone 484 526-7349
Certificate Type Certificate for Provider-Performed Microscopy Procedures (PPMP)
Certificate Type Description This certificate is issued to a laboratory in which a physician, midlevel practitioner or dentist performs no tests other than the microscopy procedures. This certificate permits the laboratory to also perform waived tests.
Certificate Effective Date 1/23/2024
Certificate Expiration Date 1/22/2026
Facility Type Physician Office
Lab Director ANDREW C. KRAKOWSKI

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