39D0657848 CLIA NUMBER - WEST PHILADELPHIA DIALYSIS

Laboratory Demographics

CLIA Number: 39D0657848

Facility Name: WEST PHILADELPHIA DIALYSIS

Facility Address:
7609 LINDBERGH BLVD
PHILADELPHIA, PA
ZIP 19153
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Facility Phone Number: 215 937-1103

Facility Type: End Stage Renal Disease Dialysis Facility

Certificate Type: Waiver

NPI Number: 1285099598

Taxonomy: 320800000X - Community Based Residential Treatment Facility, Mental Illness
A home-like residential facility providing psychiatric treatment and psycho/social rehabilitative services to individuals diagnosed with mental illness.

CLIA Record

Field Name	Field Value
CLIA Number	39D0657848
LAB Type	End Stage Renal Disease Dialysis Facility
Facility Name	WEST PHILADELPHIA DIALYSIS
Street	7609 LINDBERGH BLVD
City	PHILADELPHIA
State	PA
ZIP	19153
Phone	215 937-1103
CertificateType	4
CertificateEffectiveDate	9/1/2022
CertificateExpirationDate	8/31/2024
FacilityType	Waiver

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