39D2030066 CLIA NUMBER - ESPERANZA HEALTH CENTER-6TH ST

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Laboratory Demographics

CLIA Number: 39D2030066

Facility Name: ESPERANZA HEALTH CENTER-6TH ST

Facility Address:
4417 N 6TH STREET
PHILADELPHIA, PA
ZIP 19140
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Facility Phone Number: 215 302-3600

Facility Type: Federally Qualified Health Center

Certificate Type: Microscopy

NPI Number: 1306933346

Taxonomy: 261QF0400X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	39D2030066
LAB Type	Federally Qualified Health Center
Facility Name	ESPERANZA HEALTH CENTER-6TH ST
Street	4417 N 6TH STREET
City	PHILADELPHIA
State	PA
ZIP	19140
Phone	215 302-3600
CertificateType	3
CertificateEffectiveDate	9/21/2023
CertificateExpirationDate	9/20/2025
FacilityType	PPMP

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