39D2062162 CLIA NUMBER - CHELTENHAM DIALYSIS

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Laboratory Demographics

CLIA Number: 39D2062162

Facility Name: CHELTENHAM DIALYSIS

Facility Address:
133 CHELTENHAM AVE
CHELTENHAM, PA
ZIP 19012
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Facility Phone Number: 215 635-1870

Facility Type: End Stage Renal Disease Dialysis Facility

Certificate Type: Waiver

NPI Number: 1750624425

Taxonomy: 261QE0700X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	39D2062162
LAB Type	End Stage Renal Disease Dialysis Facility
Facility Name	CHELTENHAM DIALYSIS
Street	133 CHELTENHAM AVE
City	CHELTENHAM
State	PA
ZIP	19012
Phone	215 635-1870
CertificateType	4
CertificateEffectiveDate	7/11/2023
CertificateExpirationDate	7/10/2025
FacilityType	Waiver

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