39D2297675 CLIA NUMBER - WELLSPAN OBGYN SELINSGROVE SPEC CLINIC

Laboratory Demographics

  • CLIA Code: 39D2297675
  • Facility Name: WELLSPAN OBGYN SELINSGROVE SPEC CLINIC
  • Facility Address: 21 SUSQUEHANNA VALLEY MALL DRIVE, STE C
    SELINSGROVE, PA
    ZIP 17870
  • Facility Phone: 570 523-8700
  • Facility Type: Physician Office
  • Facility Type: Microscopy
  • Lab Director: DR. ALLISON A. MCOWEN
  • NPI Number: 1609678572
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 39D2297675
LAB Type Physician Office
Facility Name WELLSPAN OBGYN SELINSGROVE SPEC CLINIC
Street 21 SUSQUEHANNA VALLEY MALL DRIVE, STE C
City SELINSGROVE
State PA
ZIP 17870
Phone 570 523-8700
Certificate Type Certificate for Provider-Performed Microscopy Procedures (PPMP)
Certificate Type Description This certificate is issued to a laboratory in which a physician, midlevel practitioner or dentist performs no tests other than the microscopy procedures. This certificate permits the laboratory to also perform waived tests.
Certificate Effective Date 1/19/2024
Certificate Expiration Date 1/18/2026
Facility Type Physician Office
Lab Director DR. ALLISON A. MCOWEN

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