39D2049634 CLIA NUMBER - FADEMOS FAMILY PRACTICE

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Laboratory Demographics

CLIA Number: 39D2049634

Facility Name: FADEMOS FAMILY PRACTICE

Facility Address:
16 OLD ASHTON RD SUITE 1
PHILADELPHIA, PA
ZIP 19152
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Facility Phone Number: (215) 613-5069

Facility Type: PHYSICIAN OFFICE

Certificate Type: Microscopy

NPI Number: 1801138896

Taxonomy: 261QP2300X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	39D2049634
LAB Type	PHYSICIAN OFFICE
Facility Name	FADEMOS FAMILY PRACTICE
Street	16 OLD ASHTON RD SUITE 1
City	PHILADELPHIA
State	PA
ZIP	19152
Phone	(215) 613-5069

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This page was last updated on: 5/11/2023