39D0992583 CLIA NUMBER - CENTENNIAL HEALTHCARE & REHAB CTR

Laboratory Demographics

  • CLIA Code: 39D0992583
  • Facility Name: CENTENNIAL HEALTHCARE & REHAB CTR
  • Facility Address: 4400 WEST GIRARD AVENUE
    PHILADELPHIA, PA
    ZIP 19104
  • Facility Phone: 215 477-1170
  • Facility Type: Skilled Nursing Facility/Nursing Facility
  • Facility Type: Waiver
  • Lab Director: DR. JOHN S. MICHEL
  • NPI Number: 1861760522
  • Taxonomy: 314000000X - Skilled Nursing Facility

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CLIA Record

Field Name Field Value
CLIA Number 39D0992583
LAB Type Skilled Nursing Facility/Nursing Facility
Facility Name CENTENNIAL HEALTHCARE & REHAB CTR
Street 4400 WEST GIRARD AVENUE
City PHILADELPHIA
State PA
ZIP 19104
Phone 215 477-1170
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/8/2024
Certificate Expiration Date 8/7/2026
Facility Type Skilled Nursing Facility/Nursing Facility
Lab Director DR. JOHN S. MICHEL

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