39D0987154 CLIA NUMBER - CITY LINE PEDIATRICS PC

Laboratory Demographics

CLIA Number: 39D0987154

Facility Name: CITY LINE PEDIATRICS PC

Facility Address:
4190 CITY LINE AVENUE SUITE 540
PHILADELPHIA, PA
ZIP 19131
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Facility Phone Number: 215 871-1800

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1477588135

Taxonomy: 208000000X - Pediatrics
A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development.

CLIA Record

Field Name	Field Value
CLIA Number	39D0987154
LAB Type	Physician Office
Facility Name	CITY LINE PEDIATRICS PC
Street	4190 CITY LINE AVENUE SUITE 540
City	PHILADELPHIA
State	PA
ZIP	19131
Phone	215 871-1800
CertificateType	4
CertificateEffectiveDate	5/30/2023
CertificateExpirationDate	5/29/2025
FacilityType	Waiver

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