39D2258334 CLIA NUMBER - SULLIVAN COUNTY LHC

Laboratory Demographics

  • CLIA Code: 39D2258334
  • Facility Name: SULLIVAN COUNTY LHC
  • Facility Address: 217 KING STREET
    LAPORTE, PA
    ZIP 18626
  • Facility Phone: 570 704-4651
  • Facility Type: Federally Qualified Health Center
  • Facility Type: Waiver
  • Lab Director: DR. SAMUEL E. SCHRACK
  • NPI Number: 1437254877
  • Taxonomy: 251300000X - Local Education Agency (LEA)

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CLIA Record

Field Name Field Value
CLIA Number 39D2258334
LAB Type Federally Qualified Health Center
Facility Name SULLIVAN COUNTY LHC
Street 217 KING STREET
City LAPORTE
State PA
ZIP 18626
Phone 570 704-4651
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/20/2024
Certificate Expiration Date 4/19/2026
Facility Type Federally Qualified Health Center
Lab Director DR. SAMUEL E. SCHRACK

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