39D2289763 CLIA NUMBER - HAZLETON MEDICAL PRACTICE, LLC

Laboratory Demographics

  • CLIA Code: 39D2289763
  • Facility Name: HAZLETON MEDICAL PRACTICE, LLC
  • Facility Address: 141 NORTH CEDAR ST
    HAZLETON, PA
    ZIP 18201
  • Facility Phone: (646) 284-8054
  • Facility Type: Practitioner Other
  • Facility Type: Waiver
  • Lab Director: DR. PEDRO GUZMAN
  • NPI Number: 1740691955
  • Taxonomy: 207R00000X - Internal Medicine

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CLIA Record

Field Name Field Value
CLIA Number 39D2289763
LAB Type Practitioner Other
Facility Name HAZLETON MEDICAL PRACTICE, LLC
Street 141 NORTH CEDAR ST
City HAZLETON
State PA
ZIP 18201
Phone 6462848054
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/15/2025
Certificate Expiration Date 9/14/2027
Facility Type Practitioner Other
Lab Director DR. PEDRO GUZMAN

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This page was last updated on: 5/18/2026