39D1010557 CLIA NUMBER - MAIN LINE ENDOSCOPY CENTER MALVERN

Laboratory Demographics

  • CLIA Code: 39D1010557
  • Facility Name: MAIN LINE ENDOSCOPY CENTER MALVERN
  • Facility Address: 700 STEEL LANE, STE 100
    MALVERN, PA
    ZIP 19355
  • Facility Phone: 610 644-7274
  • Facility Type: Ambulatory Surgery Center
  • Facility Type: Waiver
  • Lab Director: DR. MICHAEL B. WOLFSON
  • NPI Number: 1871569780
  • Taxonomy: 261QE0800X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 39D1010557
LAB Type Ambulatory Surgery Center
Facility Name MAIN LINE ENDOSCOPY CENTER MALVERN
Street 700 STEEL LANE, STE 100
City MALVERN
State PA
ZIP 19355
Phone 610 644-7274
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/18/2025
Certificate Expiration Date 3/17/2027
Facility Type Ambulatory Surgery Center
Lab Director DR. MICHAEL B. WOLFSON

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