39D0194801 CLIA NUMBER - BALA CYNWYD MEDICAL ASSOCIATES

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Laboratory Demographics

CLIA Number: 39D0194801

Facility Name: BALA CYNWYD MEDICAL ASSOCIATES

Facility Address:
2 BALA PLAZA SUITE IL-27
BALA CYNWYD, PA
ZIP 19004
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Facility Phone Number: 610 668-9999

Facility Type: Independent

Certificate Type: Waiver

NPI Number: 1285087106

Taxonomy: 261QA1903X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	39D0194801
LAB Type	Independent
Facility Name	BALA CYNWYD MEDICAL ASSOCIATES
Street	2 BALA PLAZA SUITE IL-27
City	BALA CYNWYD
State	PA
ZIP	19004
Phone	610 668-9999
CertificateType	4
CertificateEffectiveDate	6/10/2022
CertificateExpirationDate	6/9/2024
FacilityType	Waiver

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