39D0906590 CLIA NUMBER - MEMPHIS STREET RENAL CENTER

Laboratory Demographics

  • CLIA Code: 39D0906590
  • Facility Name: MEMPHIS STREET RENAL CENTER
  • Facility Address: 3310 - 24 MEMPHIS STREET
    PHILADELPHIA, PA
    ZIP 19134
  • Facility Phone: 215 739-9558
  • Facility Type: End Stage Renal Disease Dialysis Facility
  • Facility Type: Waiver
  • Lab Director: DR. JOHN E. SHULMAN MD
  • NPI Number: 1376580464
  • Taxonomy: 261QE0700X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 39D0906590
LAB Type End Stage Renal Disease Dialysis Facility
Facility Name MEMPHIS STREET RENAL CENTER
Street 3310 - 24 MEMPHIS STREET
City PHILADELPHIA
State PA
ZIP 19134
Phone 215 739-9558
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/3/2025
Certificate Expiration Date 10/2/2027
Facility Type End Stage Renal Disease Dialysis Facility
Lab Director DR. JOHN E. SHULMAN MD

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