39D0202596 CLIA NUMBER - EVANGELICAL MANOR D/B/A WESLEY ENHANCED LIVING

Laboratory Demographics

  • CLIA Code: 39D0202596
  • Facility Name: EVANGELICAL MANOR D/B/A WESLEY ENHANCED LIVING
  • Facility Address: 8401 ROOSEVELT BOULEVARD
    PHILADELPHIA, PA
    ZIP 19152
  • Facility Phone: 215 624-5800
  • Facility Type: Skilled Nursing Facility/Nursing Facility
  • Facility Type: Waiver
  • Lab Director: DR. RODNEY M. ELKIN
  • NPI Number: 1043207152
  • Taxonomy: 314000000X - Skilled Nursing Facility

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CLIA Record

Field Name Field Value
CLIA Number 39D0202596
LAB Type Skilled Nursing Facility/Nursing Facility
Facility Name EVANGELICAL MANOR D/B/A WESLEY ENHANCED LIVING
Street 8401 ROOSEVELT BOULEVARD
City PHILADELPHIA
State PA
ZIP 19152
Phone 215 624-5800
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/1/2024
Certificate Expiration Date 8/31/2026
Facility Type Skilled Nursing Facility/Nursing Facility
Lab Director DR. RODNEY M. ELKIN

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