39D2206395 CLIA NUMBER - LEBANON COUNTY CORRECTIONAL FACILITY

Laboratory Demographics

  • CLIA Code: 39D2206395
  • Facility Name: LEBANON COUNTY CORRECTIONAL FACILITY
  • Facility Address: 730 EAST WALNUT STREET
    LEBANON, PA
    ZIP 17042
  • Facility Phone: 717 274-5435
  • Facility Type: Prison
  • Facility Type: Waiver
  • Lab Director: DR. KENNETH R. WLOCZEWSKI
  • NPI Number: 1093141814
  • Taxonomy: 261QE0700X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 39D2206395
LAB Type Prison
Facility Name LEBANON COUNTY CORRECTIONAL FACILITY
Street 730 EAST WALNUT STREET
City LEBANON
State PA
ZIP 17042
Phone 717 274-5435
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 12/19/2024
Certificate Expiration Date 12/18/2026
Facility Type Prison
Lab Director DR. KENNETH R. WLOCZEWSKI

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