39D0199133 CLIA NUMBER - FOX CHASE PEDIATRICS

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Laboratory Demographics

CLIA Number: 39D0199133

Facility Name: FOX CHASE PEDIATRICS

Facility Address:
7500 CENTRAL AVE SUITE 205
PHILADELPHIA, PA
ZIP 19111
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Facility Phone Number: 215 728-7711

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1952674079

Taxonomy: 2085R0001X - Radiology
A radiologist who deals with the therapeutic applications of radiant energy and its modifiers and the study and management of disease, especially malignant tumors.

CLIA Record

Field Name	Field Value
CLIA Number	39D0199133
LAB Type	Physician Office
Facility Name	FOX CHASE PEDIATRICS
Street	7500 CENTRAL AVE SUITE 205
City	PHILADELPHIA
State	PA
ZIP	19111
Phone	215 728-7711
CertificateType	4
CertificateEffectiveDate	4/12/2023
CertificateExpirationDate	4/11/2025
FacilityType	Waiver

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