39D2247085 CLIA NUMBER - DEVEREUX ADVANCED BEHAVIORAL HEALTH

Laboratory Demographics

CLIA Code: 39D2247085
Facility Name: DEVEREUX ADVANCED BEHAVIORAL HEALTH
Facility Address: 1547 MILL CREEK ROAD
NEWFOUNDLAND, PA
ZIP 18445
Facility Phone: 570 839-6146
Facility Type: Other - IDD RESIDENTIAL PCH
Facility Type: Waiver
Lab Director: DR. YOLANDA P. GRAHAM
NPI Number: 1871067942
Taxonomy: 320900000X - Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities

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CLIA Record

Field Name	Field Value
CLIA Number	39D2247085
LAB Type	Other - IDD RESIDENTIAL PCH
Facility Name	DEVEREUX ADVANCED BEHAVIORAL HEALTH
Street	1547 MILL CREEK ROAD
City	NEWFOUNDLAND
State	PA
ZIP	18445
Phone	570 839-6146
Certificate Type	Certificate of Waiver
Certificate Type Description	This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date	1/4/2024
Certificate Expiration Date	1/3/2026
Facility Type	Other - IDD RESIDENTIAL PCH
Lab Director	DR. YOLANDA P. GRAHAM

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