39D1078755 CLIA NUMBER - RITTENHOUSE INTERNAL MEDICINE

Laboratory Demographics

  • CLIA Code: 39D1078755
  • Facility Name: RITTENHOUSE INTERNAL MEDICINE
  • Facility Address: 1632 PINE STREET
    PHILADELPHIA, PA
    ZIP 19103
  • Facility Phone: 215 735-7992
  • Facility Type: Physician Office
  • Facility Type: Microscopy
  • Lab Director: DR. MARIA MAZZOTTI
  • NPI Number: 1508098377
  • Taxonomy: 133V00000X - Dietitian, Registered

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CLIA Record

Field Name Field Value
CLIA Number 39D1078755
LAB Type Physician Office
Facility Name RITTENHOUSE INTERNAL MEDICINE
Street 1632 PINE STREET
City PHILADELPHIA
State PA
ZIP 19103
Phone 215 735-7992
Certificate Type Certificate for Provider-Performed Microscopy Procedures (PPMP)
Certificate Type Description This certificate is issued to a laboratory in which a physician, midlevel practitioner or dentist performs no tests other than the microscopy procedures. This certificate permits the laboratory to also perform waived tests.
Certificate Effective Date 1/16/2024
Certificate Expiration Date 1/15/2026
Facility Type Physician Office
Lab Director DR. MARIA MAZZOTTI

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