39D2059394 CLIA NUMBER - VINCERA SURGERY CENTER, LLC WILLIAM MEYERS MBR

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Laboratory Demographics

CLIA Number: 39D2059394

Facility Name: VINCERA SURGERY CENTER, LLC WILLIAM MEYERS MBR

Facility Address:
1200 CONSTITUTION AVE, SUITE 100
PHILADELPHIA, PA
ZIP 19112
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Facility Phone Number: 215 755-2334

Facility Type: Ambulatory Surgery Center

Certificate Type: Waiver

NPI Number: 1366886913

Taxonomy: 261QA1903X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	39D2059394
LAB Type	Ambulatory Surgery Center
Facility Name	VINCERA SURGERY CENTER, LLC WILLIAM MEYERS MBR
Street	1200 CONSTITUTION AVE, SUITE 100
City	PHILADELPHIA
State	PA
ZIP	19112
Phone	215 755-2334
CertificateType	4
CertificateEffectiveDate	5/22/2023
CertificateExpirationDate	5/21/2025
FacilityType	Waiver

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