39D2023415 CLIA NUMBER - MARIA DE LOS SANTOS HEALTH CENTER

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Laboratory Demographics

CLIA Number: 39D2023415

Facility Name: MARIA DE LOS SANTOS HEALTH CENTER

Facility Address:
401-55 W ALLEGHENY AVE
PHILADELPHIA, PA
ZIP 19133
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Facility Phone Number: 215 684-5344

Facility Type: Federally Qualified Health Center

Certificate Type: Microscopy

NPI Number: 1114940582

Taxonomy: 261QF0400X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	39D2023415
LAB Type	Federally Qualified Health Center
Facility Name	MARIA DE LOS SANTOS HEALTH CENTER
Street	401-55 W ALLEGHENY AVE
City	PHILADELPHIA
State	PA
ZIP	19133
Phone	215 684-5344
CertificateType	3
CertificateEffectiveDate	4/22/2023
CertificateExpirationDate	4/21/2025
FacilityType	PPMP

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