39D1035649 CLIA NUMBER - TEMPLE FAMILY MEDICINE AT FT WASHINGTON

Laboratory Demographics

  • CLIA Code: 39D1035649
  • Facility Name: TEMPLE FAMILY MEDICINE AT FT WASHINGTON
  • Facility Address: 515 PENNSYLVANIA AVENUE, SUITE A
    FORT WASHINGTON, PA
    ZIP 19034
  • Facility Phone: (215) 540-8408
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: MARK OBENRADER MD
  • NPI Number: 1679624498
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 39D1035649
LAB Type Physician Office
Facility Name TEMPLE FAMILY MEDICINE AT FT WASHINGTON
Street 515 PENNSYLVANIA AVENUE, SUITE A
City FORT WASHINGTON
State PA
ZIP 19034
Phone 2155408408
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 1/7/2025
Certificate Expiration Date 1/6/2027
Facility Type Physician Office
Lab Director MARK OBENRADER MD

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This page was last updated on: 5/18/2026