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39D1101910 CLIA NUMBER - MAIN LINE HEALTHCARE OB/GYN ASSOC

Laboratory Demographics

CLIA Number: 39D1101910

Facility Name: MAIN LINE HEALTHCARE OB/GYN ASSOC

Facility Address:
100 LANCASTER AVE, MOB SOUTH 307
WYNNEWOOD, PA
ZIP 19096
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Facility Phone Number: 484 572-2444

Facility Type: Physician Office

Certificate Type: Microscopy
NPI Number: 1346443496

Taxonomy: 207ND0101X - Dermatology
The highly-trained surgeons that perform Mohs Micrographic Surgery are specialists both in dermatology and pathology. With their extensive knowledge of the skin and unique pathological skills, they are able to remove only diseased tissue, preserving healthy tissue and minimizing the cosmetic impact of the surgery. Mohs surgeons who belong to the American College of Mohs Surgery (ACMS) have completed a minimum of one year of fellowship training at one of the ACMS-approved training centers in the U.S.

CLIA Record

Field Name Field Value
CLIA Number 39D1101910
LAB Type Physician Office
Facility Name MAIN LINE HEALTHCARE OB/GYN ASSOC
Street 100 LANCASTER AVE, MOB SOUTH 307
City WYNNEWOOD
State PA
ZIP 19096
Phone 484 572-2444
CertificateType 3
CertificateEffectiveDate 7/8/2023
CertificateExpirationDate 7/7/2025
FacilityType PPMP

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