39D2315801 CLIA NUMBER - GIANT PHARMACY #6014

Laboratory Demographics

  • CLIA Code: 39D2315801
  • Facility Name: GIANT PHARMACY #6014
  • Facility Address: 1278 S MARKET STREET
    ELIZABETHTOWN, PA
    ZIP 17022
  • Facility Phone: 717 367-2613
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: MICHAEL P. PORR
  • NPI Number: 1093747016
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 39D2315801
LAB Type Pharmacy
Facility Name GIANT PHARMACY #6014
Street 1278 S MARKET STREET
City ELIZABETHTOWN
State PA
ZIP 17022
Phone 717 367-2613
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 12/19/2024
Certificate Expiration Date 12/18/2026
Facility Type Pharmacy
Lab Director MICHAEL P. PORR

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