39D1065307 CLIA NUMBER - PGC ENDOSCOPY CENTER FOR EXCELLENCE

Laboratory Demographics

CLIA Number: 39D1065307

Facility Name: PGC ENDOSCOPY CENTER FOR EXCELLENCE

Facility Address:
700 COTTMAN AVENUE
PHILADELPHIA, PA
ZIP 19111
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Facility Phone Number: 215 742-9900

Facility Type: Ambulatory Surgery Center

Certificate Type: Waiver

NPI Number: 1972678449

Taxonomy: 261QE0800X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	39D1065307
LAB Type	Ambulatory Surgery Center
Facility Name	PGC ENDOSCOPY CENTER FOR EXCELLENCE
Street	700 COTTMAN AVENUE
City	PHILADELPHIA
State	PA
ZIP	19111
Phone	215 742-9900
CertificateType	4
CertificateEffectiveDate	2/27/2023
CertificateExpirationDate	2/26/2025
FacilityType	Waiver

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