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08D0982786 CLIA NUMBER - PREMISE HEALTH OF DELAWARE MEDICAL, PA

Laboratory Demographics

CLIA Number: 08D0982786

Facility Name: PREMISE HEALTH OF DELAWARE MEDICAL, PA

Facility Address:
1800 CONCORD PIKE, B2A-016
WILMINGTON, DE
ZIP 19803
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Facility Phone Number: 302 886-3241

Facility Type: Physician Office

Certificate Type: Waiver
NPI Number: 1093159220

Taxonomy: 208D00000X - General Practice
A physician who specializes in the general practice of diagnosing, treating, and managing patients with a variety of illnesses and conditions. Source: National Uniform Claim Committee

CLIA Record

Field Name Field Value
CLIA Number 08D0982786
LAB Type Physician Office
Facility Name PREMISE HEALTH OF DELAWARE MEDICAL, PA
Street 1800 CONCORD PIKE, B2A-016
City WILMINGTON
State DE
ZIP 19803
Phone 302 886-3241
CertificateType 4
CertificateEffectiveDate 2/5/2023
CertificateExpirationDate 2/4/2025
FacilityType Waiver

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This page was last updated on: 4/23/2024