39D2179395 CLIA NUMBER - WELLSPAN OCCUPATIONAL HEALTH MANCHESTER

Laboratory Demographics

  • CLIA Code: 39D2179395
  • Facility Name: WELLSPAN OCCUPATIONAL HEALTH MANCHESTER
  • Facility Address: 4050 N GEORGE STREET EXT
    MANCHESTER, PA
    ZIP 17345
  • Facility Phone: 717 356-4380
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: DR. ANNE M. VASSALLO
  • NPI Number: 1437227055
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 39D2179395
LAB Type Physician Office
Facility Name WELLSPAN OCCUPATIONAL HEALTH MANCHESTER
Street 4050 N GEORGE STREET EXT
City MANCHESTER
State PA
ZIP 17345
Phone 717 356-4380
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 2/24/2024
Certificate Expiration Date 2/23/2026
Facility Type Physician Office
Lab Director DR. ANNE M. VASSALLO

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