39D0199149 CLIA NUMBER - CENTER ONE FAMILY MEDICINE

Laboratory Demographics

  • CLIA Code: 39D0199149
  • Facility Name: CENTER ONE FAMILY MEDICINE
  • Facility Address: 9880 BUSTLETON AVENUE, SUITE 301
    PHILADELPHIA, PA
    ZIP 19115
  • Facility Phone: 215 827-1553
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: DR. RITA C. CARABELLO
  • NPI Number: 1972074250
  • Taxonomy: 261QD0000X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 39D0199149
LAB Type Physician Office
Facility Name CENTER ONE FAMILY MEDICINE
Street 9880 BUSTLETON AVENUE, SUITE 301
City PHILADELPHIA
State PA
ZIP 19115
Phone 215 827-1553
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/16/2024
Certificate Expiration Date 3/15/2026
Facility Type Physician Office
Lab Director DR. RITA C. CARABELLO

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