39D2029533 CLIA NUMBER - MINUTE CLINIC DIAGNOSTIC OF PENNSYLVANIA, LLC

Laboratory Demographics

  • CLIA Code: 39D2029533
  • Facility Name: MINUTE CLINIC DIAGNOSTIC OF PENNSYLVANIA, LLC
  • Facility Address: 6701 RIDGE AVE SIDE 1
    PHILADELPHIA, PA
    ZIP 19128
  • Facility Phone: 847 559-4662
  • Facility Type: Other - LIMITD SERV HEALTH CLINIC
  • Facility Type: Waiver
  • Lab Director: DR. DEBORAH NILES MD
  • NPI Number: 1285979179
  • Taxonomy: 282N00000X - General Acute Care Hospital

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CLIA Record

Field Name Field Value
CLIA Number 39D2029533
LAB Type Other - LIMITD SERV HEALTH CLINIC
Facility Name MINUTE CLINIC DIAGNOSTIC OF PENNSYLVANIA, LLC
Street 6701 RIDGE AVE SIDE 1
City PHILADELPHIA
State PA
ZIP 19128
Phone 847 559-4662
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/9/2025
Certificate Expiration Date 9/8/2027
Facility Type Other - LIMITD SERV HEALTH CLINIC
Lab Director DR. DEBORAH NILES MD

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