08D2176094 CLIA NUMBER - EPHPHATHA MEDICAL CARE SERVICES

Laboratory Demographics

  • CLIA Code: 08D2176094
  • Facility Name: EPHPHATHA MEDICAL CARE SERVICES
  • Facility Address: 1350 MIDDLEFORD ROAD, #501
    SEAFORD, DE
    ZIP 19973
  • Facility Phone: 925 222-9572
  • Facility Type: Practitioner Other
  • Facility Type: Waiver
  • Lab Director: EMANIE DORIVAL
  • NPI Number: 1245884048
  • Taxonomy: 208D00000X - General Practice

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CLIA Record

Field Name Field Value
CLIA Number 08D2176094
LAB Type Practitioner Other
Facility Name EPHPHATHA MEDICAL CARE SERVICES
Street 1350 MIDDLEFORD ROAD, #501
City SEAFORD
State DE
ZIP 19973
Phone 925 222-9572
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 12/9/2023
Certificate Expiration Date 12/8/2025
Facility Type Practitioner Other
Lab Director EMANIE DORIVAL

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