39D0972461 CLIA NUMBER - THMA- MG GASTROENTEROLOGY RHAWN

Laboratory Demographics

CLIA Number: 39D0972461

Facility Name: THMA- MG GASTROENTEROLOGY RHAWN

Facility Address:
1403 RHAWN STREET
PHILADELPHIA, PA
ZIP 19111
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Facility Phone Number: 215 332-8100

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1710447016

Taxonomy: 207RG0100X - Internal Medicine
An internist who specializes in diagnosis and treatment of diseases of the digestive organs including the stomach, bowels, liver and gallbladder. This specialist treats conditions such as abdominal pain, ulcers, diarrhea, cancer and jaundice and performs complex diagnostic and therapeutic procedures using endoscopes to visualize internal organs.

CLIA Record

Field Name	Field Value
CLIA Number	39D0972461
LAB Type	Physician Office
Facility Name	THMA- MG GASTROENTEROLOGY RHAWN
Street	1403 RHAWN STREET
City	PHILADELPHIA
State	PA
ZIP	19111
Phone	215 332-8100
CertificateType	4
CertificateEffectiveDate	3/28/2023
CertificateExpirationDate	3/27/2025
FacilityType	Waiver

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