39D0672730 CLIA NUMBER - MT AIRY PEDIATRICS

Laboratory Demographics

  • CLIA Code: 39D0672730
  • Facility Name: MT AIRY PEDIATRICS
  • Facility Address: 6673 GERMANTOWN AVE
    PHILADELPHIA, PA
    ZIP 19119
  • Facility Phone: (215) 247-2996
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: DR. MARCIE E. MACOLINO
  • NPI Number: 1790727295
  • Taxonomy: 208000000X - Pediatrics

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CLIA Record

Field Name Field Value
CLIA Number 39D0672730
LAB Type Physician Office
Facility Name MT AIRY PEDIATRICS
Street 6673 GERMANTOWN AVE
City PHILADELPHIA
State PA
ZIP 19119
Phone 2152472996
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 Physician Office
Lab Director DR. MARCIE E. MACOLINO

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This page was last updated on: 5/18/2026