39D0877550 CLIA NUMBER - ST CHRISCARE AT NE PEDIATRICS

Laboratory Demographics

CLIA Number: 39D0877550

Facility Name: ST CHRISCARE AT NE PEDIATRICS

Facility Address:
9501 ROOSEVELT BOULEVARD SUITE 305
PHILADELPHIA, PA
ZIP 19114
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Facility Phone Number: 215 969-4917

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1043379506

Taxonomy: 208000000X - Pediatrics
A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development.

CLIA Record

Field Name	Field Value
CLIA Number	39D0877550
LAB Type	Physician Office
Facility Name	ST CHRISCARE AT NE PEDIATRICS
Street	9501 ROOSEVELT BOULEVARD SUITE 305
City	PHILADELPHIA
State	PA
ZIP	19114
Phone	215 969-4917
CertificateType	4
CertificateEffectiveDate	6/1/2023
CertificateExpirationDate	5/31/2025
FacilityType	Waiver

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