NORTHERN WAYNE HEALTH CENTER
NPI 1669654596
Clinic/Center - Federally Qualified Health Center (FQHC) in Lake Como, PA

Active since December 03, 2007CLIA 39D0921485 · Waiver
412 COMO ROAD, LAKE COMO, PA 18437(570) 798-2828(570) 798-2636 Get Directions Write a Review

NPPES record last updated: April 7, 2015. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Northern Wayne Health Center NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

NORTHERN WAYNE HEALTH CENTER (NPI 1669654596) is a healthcare organization registered as a federally qualified health center (fqhc) in Lake Como, Pennsylvania and active in the NPI registry since December 2007. The organization holds a CLIA Waiver certificate valid through October 28, 2026 and lists Frederick Jackson, Executive Director, as its authorized official.

NPPES Registry Identity

NPI1669654596
Entity TypeOrganization
Primary Taxonomy261QF0400X
Legal Business NameWAYNE MEMORIAL COMMUNITY HEALTH CENTERS
Location Address412 COMO ROADLake Como, PA 18437-0000
Mailing Address601 Park StHonesdale, PA 18431-1445 · (570) 253-8226
Fax(570) 798-2636
Organization SubpartNo
Authorized OfficialFrederick JacksonExecutive Director · (570) 253-8450
Enumeration DateDecember 3, 2007
Last NPPES UpdateApril 7, 2015
NPI 1669654596 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

Primary SpecialtyClinic/Center · Federally Qualified Health Center (FQHC)Ambulatory Health Care Facilities
Taxonomy Code261QF0400X
Also ListedFamily MedicineTaxonomy 207Q00000X · License OS011217 (PA)
Also ListedInternal MedicineTaxonomy 207R00000X · License MD428487 (PA)
412 COMO ROAD, Lake Como, PA 18437

Other Names 1

Doing Business AsNorthern Wayne Health Center

Other Identifiers 4

Medicaid1007765560005PA
Medicare OSCAR/certification559496WI
Medicare PIN559496PA
Medicare OSCAR/certification391982WI

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Accepted Insurance

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 39D0921485

Northern Wayne Family Health Center · Lake Como, PA
Active · expires Oct 28, 2026
CLIA Number39D0921485
Laboratory TypePhysician Office
Certificate Effective DateOctober 29, 2024
Certificate Expiration DateOctober 28, 2026
Laboratory DirectorDr. Richard K. Hacker MD
Laboratory Phone(570) 798-2828
Laboratory LocationNorthern Wayne Family Health Center412 Como Road, Lake Como, PA 18437
CLIA data matches this NPI record on: Address Phone
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Nurse Practitioner (Adult Health)
412 COMO ROAD
LAKE COMO, PA 18437

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Wayne Memorial Community Health Centers's NPI number?

The NPI number for Wayne Memorial Community Health Centers is 1669654596. It was assigned to this organization in the NPPES registry on December 3, 2007. The provider is doing business as Northern Wayne Health Center.

Where is Wayne Memorial Community Health Centers located?

Wayne Memorial Community Health Centers is located at 412 Como Road, Lake Como, PA 18437. The listed phone number is (570) 798-2828.

What is Wayne Memorial Community Health Centers's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Federally Qualified Health Center (FQHC), with taxonomy code 261QF0400X.

Does Wayne Memorial Community Health Centers hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 39D0921485) is associated with this NPI, valid through October 28, 2026. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

What insurance does Wayne Memorial Community Health Centers accept?

Health plans from Ambetter Health, Ambetter Health of Delaware, Ambetter from Buckeye Health Plan, Florida Blue (BlueCross BlueShield FL) and Florida Blue HMO (a BlueCross BlueShield FL company) list Wayne Memorial Community Health Centers as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Wayne Memorial Community Health Centers was last updated on April 7, 2015. NPI Profile syncs with the weekly NPPES data releases published by CMS.