39D2040893 CLIA NUMBER - BUTTONWOOD DIALYSIS

Laboratory Demographics

  • CLIA Code: 39D2040893
  • Facility Name: BUTTONWOOD DIALYSIS
  • Facility Address: 449 N BROAD STREET
    PHILADELPHIA, PA
    ZIP 19123
  • Facility Phone: 215 238-1201
  • Facility Type: End Stage Renal Disease Dialysis Facility
  • Facility Type: Waiver
  • Lab Director: DR. ELLIE KELEPOURIS MD
  • NPI Number: 1881968774
  • Taxonomy: 261QE0700X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 39D2040893
LAB Type End Stage Renal Disease Dialysis Facility
Facility Name BUTTONWOOD DIALYSIS
Street 449 N BROAD STREET
City PHILADELPHIA
State PA
ZIP 19123
Phone 215 238-1201
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 5/11/2024
Certificate Expiration Date 5/10/2026
Facility Type End Stage Renal Disease Dialysis Facility
Lab Director DR. ELLIE KELEPOURIS MD

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