39D2190179 CLIA NUMBER - WELLSPAN URGENT CARE - ANNVILLE

Laboratory Demographics

  • CLIA Code: 39D2190179
  • Facility Name: WELLSPAN URGENT CARE - ANNVILLE
  • Facility Address: 9 NATHAN LANE
    ANNVILLE, PA
    ZIP 17003
  • Facility Phone: 717 639-3350
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: DR. CRESTON TATE
  • NPI Number: 1467072553
  • Taxonomy: 261QU0200X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 39D2190179
LAB Type Physician Office
Facility Name WELLSPAN URGENT CARE - ANNVILLE
Street 9 NATHAN LANE
City ANNVILLE
State PA
ZIP 17003
Phone 717 639-3350
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/11/2024
Certificate Expiration Date 8/10/2026
Facility Type Physician Office
Lab Director DR. CRESTON TATE

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