39D0903471 CLIA NUMBER - CLINICAL LAB - CELLULAR THERAPY

Laboratory Demographics

CLIA Number: 39D0903471

Facility Name: CLINICAL LAB - CELLULAR THERAPY

Facility Address:
1100 WALNUT STREET MOB, SUITE 801
PHILADELPHIA, PA
ZIP 19107
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Facility Phone Number: 215 955-9646

Facility Type: Hospital

Certificate Type: Certificate of Compliance

NPI Number: 1225576978

Taxonomy: 261QA1903X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	39D0903471
LAB Type	Hospital
Facility Name	CLINICAL LAB - CELLULAR THERAPY
Street	1100 WALNUT STREET MOB, SUITE 801
City	PHILADELPHIA
State	PA
ZIP	19107
Phone	215 955-9646
CertificateType	2
CertificateEffectiveDate	10/22/2023
CertificateExpirationDate	10/21/2025
FacilityType	Compliance

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