39D2267693 CLIA NUMBER - WMC PHYSICIAN PRACTICES, LLC

Laboratory Demographics

CLIA Number: 39D2267693

Facility Name: WMC PHYSICIAN PRACTICES, LLC

Facility Address:
400 MARKET PLACE DRIVE
OAKDALE, PA
ZIP 15071
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Facility Phone Number: 724 218-1931

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1386026888

Taxonomy: 174400000X - Specialist
An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.

CLIA Record

Field Name	Field Value
CLIA Number	39D2267693
LAB Type	Physician Office
Facility Name	WMC PHYSICIAN PRACTICES, LLC
Street	400 MARKET PLACE DRIVE
City	OAKDALE
State	PA
ZIP	15071
Phone	724 218-1931
CertificateType	4
CertificateEffectiveDate	8/30/2022
CertificateExpirationDate	8/29/2024
FacilityType	Waiver

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