39D0194492 CLIA NUMBER - HYPERTENSION NEPHROLOGY

Laboratory Demographics

  • CLIA Code: 39D0194492
  • Facility Name: HYPERTENSION NEPHROLOGY
  • Facility Address: 735 FITZWATERTOWN ROAD
    WILLOW GROVE, PA
    ZIP 19090
  • Facility Phone: (215) 657-2012
  • Facility Type: Physician Office
  • Facility Type: Microscopy
  • Lab Director: DR. VICTOR E. GHANTOUS
  • NPI Number: 1639565138
  • Taxonomy: 261QE0700X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 39D0194492
LAB Type Physician Office
Facility Name HYPERTENSION NEPHROLOGY
Street 735 FITZWATERTOWN ROAD
City WILLOW GROVE
State PA
ZIP 19090
Phone 2156572012
Certificate Type Certificate for Provider-Performed Microscopy Procedures (PPMP)
Certificate Type Description This certificate is issued to a laboratory in which a physician, midlevel practitioner or dentist performs no tests other than the microscopy procedures. This certificate permits the laboratory to also perform waived tests.
Certificate Effective Date 9/1/2024
Certificate Expiration Date 8/31/2026
Facility Type Physician Office
Lab Director DR. VICTOR E. GHANTOUS

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This page was last updated on: 5/18/2026