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39D1084771 CLIA NUMBER - ROXBOROUGH IM

Laboratory Demographics

CLIA Number: 39D1084771

Facility Name: ROXBOROUGH IM

Facility Address:
6001 RIDGE AVENUE
PHILADELPHIA, PA
ZIP 19128
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Facility Phone Number: 215 487-2260

Facility Type: Physician Office

Certificate Type: Waiver
NPI Number: 1538250477

Taxonomy: 207P00000X - Emergency Medicine
An emergency physician focuses on the immediate decision making and action necessary to prevent death or any further disability both in the pre-hospital setting by directing emergency medical technicians and in the emergency department. The emergency physician provides immediate recognition, evaluation, care, stabilization and disposition of a generally diversified population of adult and pediatric patients in response to acute illness and injury.

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
CertificateType 4
CertificateEffectiveDate 9/19/2022
CertificateExpirationDate 9/18/2024
FacilityType Waiver

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