39D0726389 CLIA NUMBER - TEMPLE FACULTY PHYSICIANS- OBGYN

Laboratory Demographics

  • CLIA Code: 39D0726389
  • Facility Name: TEMPLE FACULTY PHYSICIANS- OBGYN
  • Facility Address: 3401 NORTH BROAD STREET ZONE C 3RD FL, RM 310
    PHILADELPHIA, PA
    ZIP 19140
  • Facility Phone: 215 707-1383
  • Facility Type: Other
  • Facility Type: Microscopy
  • Lab Director: DR. WADIA R. MULLA
  • NPI Number: 1972086650
  • Taxonomy: 207ZP0101X - Pathology

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CLIA Record

Field Name Field Value
CLIA Number 39D0726389
LAB Type Other
Facility Name TEMPLE FACULTY PHYSICIANS- OBGYN
Street 3401 NORTH BROAD STREET ZONE C 3RD FL, RM 310
City PHILADELPHIA
State PA
ZIP 19140
Phone 215 707-1383
Certificate Type Certificate for Provider-Performed Microscopy Procedures (PPMP)
Certificate Type Description This certificate is issued to a laboratory in which a physician, midlevel practitioner or dentist performs no tests other than the microscopy procedures. This certificate permits the laboratory to also perform waived tests.
Certificate Effective Date 9/1/2024
Certificate Expiration Date 8/31/2026
Facility Type Other
Lab Director DR. WADIA R. MULLA

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