39D2291691 CLIA NUMBER - LAKOTA FAMILY PRACTICE

Laboratory Demographics

  • CLIA Code: 39D2291691
  • Facility Name: LAKOTA FAMILY PRACTICE
  • Facility Address: 702 CHURCH STREET
    HAWLEY, PA
    ZIP 18428
  • Facility Phone: 272 336-0101
  • Facility Type: Practitioner Other
  • Facility Type: Waiver
  • Lab Director: DR. HAZEL M. BLUESTEIN
  • NPI Number: 1205533031
  • Taxonomy: 363LF0000X - Nurse Practitioner

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CLIA Record

Field Name Field Value
CLIA Number 39D2291691
LAB Type Practitioner Other
Facility Name LAKOTA FAMILY PRACTICE
Street 702 CHURCH STREET
City HAWLEY
State PA
ZIP 18428
Phone 272 336-0101
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/14/2025
Certificate Expiration Date 10/13/2027
Facility Type Practitioner Other
Lab Director DR. HAZEL M. BLUESTEIN

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