39D0913294 CLIA NUMBER - CONCENTRA PHILADELPHIA NORTHEAST AMERICAN CURRENT CARE, PA

Laboratory Demographics

CLIA Number: 39D0913294

Facility Name: CONCENTRA PHILADELPHIA NORTHEAST AMERICAN CURRENT CARE, PA

Facility Address:
2010 LEVICK STREET
PHILADELPHIA, PA
ZIP 19149
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Facility Phone Number: 215 537-4755

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1306965553

Taxonomy: 261QH0100X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	39D0913294
LAB Type	Physician Office
Facility Name	CONCENTRA PHILADELPHIA NORTHEAST AMERICAN CURRENT CARE, PA
Street	2010 LEVICK STREET
City	PHILADELPHIA
State	PA
ZIP	19149
Phone	215 537-4755
CertificateType	4
CertificateEffectiveDate	3/10/2023
CertificateExpirationDate	3/9/2025
FacilityType	Waiver

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