39D2210802 CLIA NUMBER - HERMITAGE PHARMACY

Laboratory Demographics

  • CLIA Code: 39D2210802
  • Facility Name: HERMITAGE PHARMACY
  • Facility Address: 1740 E STATE ST
    HERMITAGE, PA
    ZIP 16148
  • Facility Phone: (724) 983-8451
  • Facility Type: Hospital
  • Facility Type: Waiver
  • Lab Director: MATTHEW S. SHELLENBARGER
  • NPI Number: 1407949852
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 39D2210802
LAB Type Hospital
Facility Name HERMITAGE PHARMACY
Street 1740 E STATE ST
City HERMITAGE
State PA
ZIP 16148
Phone 7249838451
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 1/25/2025
Certificate Expiration Date 1/24/2027
Facility Type Hospital
Lab Director MATTHEW S. SHELLENBARGER

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This page was last updated on: 5/18/2026