39D2046438 CLIA NUMBER - MICHAEL J CRESCENZ VA OUTPATIENT DIALYSIS CENTER

Laboratory Demographics

  • CLIA Code: 39D2046438
  • Facility Name: MICHAEL J CRESCENZ VA OUTPATIENT DIALYSIS CENTER
  • Facility Address: 4219 CHESTNUT STREET
    PHILADELPHIA, PA
    ZIP 19104
  • Facility Phone: 215 222-7440
  • Facility Type: End Stage Renal Disease Dialysis Facility
  • Facility Type: Accreditation
  • Lab Director: DARSHANA JHALA
  • NPI Number: 1508122540
  • Taxonomy: 2080P0207X - Pediatrics

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CLIA Record

Field Name Field Value
CLIA Number 39D2046438
LAB Type End Stage Renal Disease Dialysis Facility
Facility Name MICHAEL J CRESCENZ VA OUTPATIENT DIALYSIS CENTER
Street 4219 CHESTNUT STREET
City PHILADELPHIA
State PA
ZIP 19104
Phone 215 222-7440
Certificate Type Certificate of Accreditation
Certificate Type Description This is a certificate that is issued to a laboratory on the basis of the laboratory's accreditation by an accreditation organization approved by CMS.
Certificate Effective Date 9/4/2012
Certificate Expiration Date 5/22/2026
Facility Type End Stage Renal Disease Dialysis Facility
Lab Director DARSHANA JHALA

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