39D2278293 CLIA NUMBER - PRISM MOLECULAR

Laboratory Demographics

  • CLIA Code: 39D2278293
  • Facility Name: PRISM MOLECULAR
  • Facility Address: 1801 MAIN STREET, SUITE 104
    BLAKELY, PA
    ZIP 18447
  • Facility Phone: 570 382-8125
  • Facility Type: Independent
  • Facility Type: Certificate of Compliance
  • Lab Director: DR. JOHN HANSON
  • NPI Number: 1558067199
  • Taxonomy: 291U00000X - Clinical Medical Laboratory

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CLIA Record

Field Name Field Value
CLIA Number 39D2278293
LAB Type Independent
Facility Name PRISM MOLECULAR
Street 1801 MAIN STREET, SUITE 104
City BLAKELY
State PA
ZIP 18447
Phone 570 382-8125
Certificate Type Certificate of Compliance
Certificate Type Description This certificate is issued to a laboratory after an inspection that finds the laboratory to be in compliance with all applicable CLIA requirements.
Certificate Effective Date 4/29/2024
Certificate Expiration Date 4/28/2026
Facility Type Independent
Lab Director DR. JOHN HANSON

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