39D2309648 CLIA NUMBER - SCHUYLKILL COUNTY CBOC

Laboratory Demographics

  • CLIA Code: 39D2309648
  • Facility Name: SCHUYLKILL COUNTY CBOC
  • Facility Address: 1410 LAUREL BLVD, SUITE 2
    POTTSVILLE, PA
    ZIP 17901
  • Facility Phone: 570 628-5374
  • Facility Type: Community Clinic
  • Facility Type: Waiver
  • Lab Director: DR. SUMAYYA FATIMA
  • NPI Number: 1346269784
  • Taxonomy: 261QE0800X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 39D2309648
LAB Type Community Clinic
Facility Name SCHUYLKILL COUNTY CBOC
Street 1410 LAUREL BLVD, SUITE 2
City POTTSVILLE
State PA
ZIP 17901
Phone 570 628-5374
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/20/2024
Certificate Expiration Date 8/19/2026
Facility Type Community Clinic
Lab Director DR. SUMAYYA FATIMA

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