39D0916326 CLIA NUMBER - PROVIDENCE REHAB AT MERCY FITZGERLAD

Laboratory Demographics

  • CLIA Code: 39D0916326
  • Facility Name: PROVIDENCE REHAB AT MERCY FITZGERLAD
  • Facility Address: 600 S WYCOMBE AVENUE
    YEADON, PA
    ZIP 19050
  • Facility Phone: 610 626-8065
  • Facility Type: Skilled Nursing Facility/Nursing Facility
  • Facility Type: Waiver
  • Lab Director: DR. SAMMY HAMID
  • NPI Number: 1043722960
  • Taxonomy: 314000000X - Skilled Nursing Facility

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CLIA Record

Field Name Field Value
CLIA Number 39D0916326
LAB Type Skilled Nursing Facility/Nursing Facility
Facility Name PROVIDENCE REHAB AT MERCY FITZGERLAD
Street 600 S WYCOMBE AVENUE
City YEADON
State PA
ZIP 19050
Phone 610 626-8065
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/27/2023
Certificate Expiration Date 8/26/2025
Facility Type Skilled Nursing Facility/Nursing Facility
Lab Director DR. SAMMY HAMID

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This page was last updated on: 6/4/2025