39D0924217 CLIA NUMBER - GPHA WOODLAND AVENUE HEALTH CENTER

Laboratory Demographics

CLIA Number: 39D0924217

Facility Name: GPHA WOODLAND AVENUE HEALTH CENTER

Facility Address:
5000 WOODLAND AVENUE
PHILADELPHIA, PA
ZIP 19143
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Facility Phone Number: 215 726-9807

Facility Type: Community Clinic

Certificate Type: Microscopy

NPI Number: 1952356867

Taxonomy: 261QF0400X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	39D0924217
LAB Type	Community Clinic
Facility Name	GPHA WOODLAND AVENUE HEALTH CENTER
Street	5000 WOODLAND AVENUE
City	PHILADELPHIA
State	PA
ZIP	19143
Phone	215 726-9807
CertificateType	3
CertificateEffectiveDate	7/23/2022
CertificateExpirationDate	7/22/2024
FacilityType	PPMP

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