39D2042840 CLIA NUMBER - FOX CHASE PAIN MANAGEMENT

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Laboratory Demographics

CLIA Number: 39D2042840

Facility Name: FOX CHASE PAIN MANAGEMENT

Facility Address:
4979 OLD STREET ROAD, SUITE B
TREVOSE, PA
ZIP 19053
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Facility Phone Number: 267 288-5601

Facility Type: Physician Office

Certificate Type: Accreditation

NPI Number: 1881649416

Taxonomy: 174400000X - Specialist
An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.

CLIA Record

Field Name	Field Value
CLIA Number	39D2042840
LAB Type	Physician Office
Facility Name	FOX CHASE PAIN MANAGEMENT
Street	4979 OLD STREET ROAD, SUITE B
City	TREVOSE
State	PA
ZIP	19053
Phone	267 288-5601
CertificateType	1
CertificateEffectiveDate	3/15/2023
CertificateExpirationDate	3/14/2025
FacilityType	Accreditation

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