39D2224965 CLIA NUMBER - DR STEPHEN JADITZ, LLC

Laboratory Demographics

CLIA Number: 39D2224965

Facility Name: DR STEPHEN JADITZ, LLC

Facility Address:
105 LAYTON RD
SOUTH ABINGTON TOWNSHIP, PA
ZIP 18411
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Facility Phone Number: 570 586-8186

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1063903151

Taxonomy: 207QG0300X - Family Medicine
A family medicine physician with special knowledge of the aging process and special skills in the diagnostic, therapeutic, preventive and rehabilitative aspects of illness in the elderly. This specialist cares for geriatric patients in the patient's home, the office, long-term care settings such as nursing homes, and the hospital.

CLIA Record

Field Name	Field Value
CLIA Number	39D2224965
LAB Type	Physician Office
Facility Name	DR STEPHEN JADITZ, LLC
Street	105 LAYTON RD
City	SOUTH ABINGTON TOWNSHIP
State	PA
ZIP	18411
Phone	570 586-8186
CertificateType	4
CertificateEffectiveDate	5/18/2023
CertificateExpirationDate	5/17/2025
FacilityType	Waiver

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This page was last updated on: 4/23/2024