39D0986677 CLIA NUMBER - JEANES FAMILY MEDICINE

Laboratory Demographics

CLIA Number: 39D0986677

Facility Name: JEANES FAMILY MEDICINE

Facility Address:
9331 OLD BUSTLETON AVENUE SUITE 101
PHILADELPHIA, PA
ZIP 19115
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Facility Phone Number: 215 673-1520

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1528395324

Taxonomy: 207Q00000X - Family Medicine
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.

CLIA Record

Field Name	Field Value
CLIA Number	39D0986677
LAB Type	Physician Office
Facility Name	JEANES FAMILY MEDICINE
Street	9331 OLD BUSTLETON AVENUE SUITE 101
City	PHILADELPHIA
State	PA
ZIP	19115
Phone	215 673-1520
CertificateType	4
CertificateEffectiveDate	8/24/2023
CertificateExpirationDate	8/23/2025
FacilityType	Waiver

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