39D2250726 CLIA NUMBER - GIANT PHARMACY #6524

Laboratory Demographics

  • CLIA Code: 39D2250726
  • Facility Name: GIANT PHARMACY #6524
  • Facility Address: 2121 S ATHERTON STREET
    STATE COLLEGE, PA
    ZIP 16801
  • Facility Phone: 814 861-2790
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: CASEY J. KULAGO
  • NPI Number: 1548294499
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 39D2250726
LAB Type Pharmacy
Facility Name GIANT PHARMACY #6524
Street 2121 S ATHERTON STREET
City STATE COLLEGE
State PA
ZIP 16801
Phone 814 861-2790
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 1/28/2024
Certificate Expiration Date 1/27/2026
Facility Type Pharmacy
Lab Director CASEY J. KULAGO

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