39D1105973 CLIA NUMBER - PENN MEDICINE HOME HEALTH

Laboratory Demographics

  • CLIA Code: 39D1105973
  • Facility Name: PENN MEDICINE HOME HEALTH
  • Facility Address: 150 MONUMENT RD, SUITE 600
    BALA CYNWYD, PA
    ZIP 19004
  • Facility Phone: 610 747-3400
  • Facility Type: Home Health Agency
  • Facility Type: Waiver
  • Lab Director: DR. SANDRA JOST
  • NPI Number: 1013582840
  • Taxonomy: 207RP1001X - Internal Medicine

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CLIA Record

Field Name Field Value
CLIA Number 39D1105973
LAB Type Home Health Agency
Facility Name PENN MEDICINE HOME HEALTH
Street 150 MONUMENT RD, SUITE 600
City BALA CYNWYD
State PA
ZIP 19004
Phone 610 747-3400
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/19/2025
Certificate Expiration Date 3/18/2027
Facility Type Home Health Agency
Lab Director DR. SANDRA JOST

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