39D0994614 CLIA NUMBER - CHILDRENS HOSP OF PHILADELPHIA CLINICS

Laboratory Demographics

CLIA Number: 39D0994614

Facility Name: CHILDRENS HOSP OF PHILADELPHIA CLINICS

Facility Address:
3550 MARKET STREET, 5TH FLOOR
PHILADELPHIA, PA
ZIP 19104
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Facility Phone Number: 215 590-0680

Facility Type: Physician Office

Certificate Type: Microscopy

NPI Number: 1891739520

Taxonomy: 282NC2000X - General Acute Care Hospital

CLIA Record

Field Name	Field Value
CLIA Number	39D0994614
LAB Type	Physician Office
Facility Name	CHILDRENS HOSP OF PHILADELPHIA CLINICS
Street	3550 MARKET STREET, 5TH FLOOR
City	PHILADELPHIA
State	PA
ZIP	19104
Phone	215 590-0680
CertificateType	3
CertificateEffectiveDate	12/27/2023
CertificateExpirationDate	12/26/2025
FacilityType	PPMP

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