39D2308756 CLIA NUMBER - PROBST FAMILY PRACTICE

Laboratory Demographics

  • CLIA Code: 39D2308756
  • Facility Name: PROBST FAMILY PRACTICE
  • Facility Address: 924 HURON AVE
    RENOVO, PA
    ZIP 17764
  • Facility Phone: 570 927-0865
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: DR. DENNIS S. PROBST
  • NPI Number: 1518710334
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 39D2308756
LAB Type Physician Office
Facility Name PROBST FAMILY PRACTICE
Street 924 HURON AVE
City RENOVO
State PA
ZIP 17764
Phone 570 927-0865
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/2/2024
Certificate Expiration Date 8/1/2026
Facility Type Physician Office
Lab Director DR. DENNIS S. PROBST

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