39D0969979 CLIA NUMBER - TARA LYN CUDA DO PC

Laboratory Demographics

  • CLIA Code: 39D0969979
  • Facility Name: TARA LYN CUDA DO PC
  • Facility Address: 2230 SOUTH BROAD STREET
    PHILADELPHIA, PA
    ZIP 19145
  • Facility Phone: 215 755-2800
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: DR. TARA L. CUDA
  • NPI Number: 1588613988
  • Taxonomy: 207R00000X - Internal Medicine

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CLIA Record

Field Name Field Value
CLIA Number 39D0969979
LAB Type Physician Office
Facility Name TARA LYN CUDA DO PC
Street 2230 SOUTH BROAD STREET
City PHILADELPHIA
State PA
ZIP 19145
Phone 215 755-2800
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 11/8/2024
Certificate Expiration Date 11/7/2026
Facility Type Physician Office
Lab Director DR. TARA L. CUDA

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