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39D2260555 CLIA NUMBER - VILLAGE IN PLACE PHYSICIAN SERVICES

Laboratory Demographics

CLIA Number: 39D2260555

Facility Name: VILLAGE IN PLACE PHYSICIAN SERVICES

Facility Address:
429 S MARKET STREET
MARTINSBURG, PA
ZIP 16662
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Facility Phone Number: 814 793-1430

Facility Type: Physician Office

Certificate Type: Waiver
NPI Number: 1477786648

Taxonomy: 251E00000X - Home Health
A public agency or private organization, or a subdivision of such an agency or organization, that is primarily engaged in providing skilled nursing services and other therapeutic services, such as physical therapy, speech-language pathology services, or occupational therapy, medical social services, and home health aide services. It has policies established by a professional group associated with the agency or organization (including at least one physician and one registered nurse) to govern the services and provides for supervision of such services by a physician or a registered nurse; maintains clinical records on all patients; is licensed in accordance with State or local law or is approved by the State or local licensing agency as meeting the licensing standards, where applicable; and meets other conditions found by the Secretary of Health and Human Services to be necessary for health and safety.

CLIA Record

Field Name Field Value
CLIA Number 39D2260555
LAB Type Physician Office
Facility Name VILLAGE IN PLACE PHYSICIAN SERVICES
Street 429 S MARKET STREET
City MARTINSBURG
State PA
ZIP 16662
Phone 814 793-1430
CertificateType 4
CertificateEffectiveDate 5/20/2022
CertificateExpirationDate 5/19/2024
FacilityType Waiver

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