39D1056318 CLIA NUMBER - NAZARETH HEALTH ENDOSCOPY CENTER

Laboratory Demographics

  • CLIA Code: 39D1056318
  • Facility Name: NAZARETH HEALTH ENDOSCOPY CENTER
  • Facility Address: 1403 RHAWN STREET
    PHILADELPHIA, PA
    ZIP 19111
  • Facility Phone: 215 728-6688
  • Facility Type: Ambulatory Surgery Center
  • Facility Type: Waiver
  • Lab Director: DR. MARK S. CODELLA
  • NPI Number: 1710447016
  • Taxonomy: 207RG0100X - Internal Medicine

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CLIA Record

Field Name Field Value
CLIA Number 39D1056318
LAB Type Ambulatory Surgery Center
Facility Name NAZARETH HEALTH ENDOSCOPY CENTER
Street 1403 RHAWN STREET
City PHILADELPHIA
State PA
ZIP 19111
Phone 215 728-6688
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/23/2025
Certificate Expiration Date 3/22/2027
Facility Type Ambulatory Surgery Center
Lab Director DR. MARK S. CODELLA

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