Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Masonic Villages of the Grand Lodge of Pennsylvania

Organization Clinical Medical Laboratory · NPI 1972856151

Masonic Villages of the Grand Lodge of Pennsylvania is a Clinical Medical Laboratory in Elizabethtown, Pennsylvania. Licensed in Pennsylvania. Registered with an NPI since 2012.

Licensed in
PA
In the registry since
2012

Practice location Address checks out

581 Freemason Dr
Elizabethtown, PA 17022-3187
Phone: (717) 367-1121
Fax: (717) 367-5813
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Clinical Medical Laboratory (primary) Taxonomy 291U00000X · Licence 000634A (PA)

Record details

NPI number1972856151
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Pamela Formica — Chief Financial Officer · (717) 367-1121
NPI enumeratedOctober 25, 2012
Last updated in NPPESMay 1, 2023
Certification dateMay 1, 2023
Mailing address1 Masonic Dr, Elizabethtown, PA 17022-2199