39D1084771 CLIA NUMBER - ROXBOROUGH IM

Laboratory Demographics

  • CLIA Code: 39D1084771
  • Facility Name: ROXBOROUGH IM
  • Facility Address: 6001 RIDGE AVENUE
    PHILADELPHIA, PA
    ZIP 19128
  • Facility Phone: 215 487-2260
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: DR. MARLENE F. GOLDWEIN
  • NPI Number: 1821020421
  • Taxonomy: 282N00000X - General Acute Care Hospital

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CLIA Record

Field Name Field Value
CLIA Number 39D1084771
LAB Type Physician Office
Facility Name ROXBOROUGH IM
Street 6001 RIDGE AVENUE
City PHILADELPHIA
State PA
ZIP 19128
Phone 215 487-2260
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/19/2024
Certificate Expiration Date 9/18/2026
Facility Type Physician Office
Lab Director DR. MARLENE F. GOLDWEIN

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