39D2073185 CLIA NUMBER - MOG HOME HEALTH CARE SERVICES

Laboratory Demographics

  • CLIA Code: 39D2073185
  • Facility Name: MOG HOME HEALTH CARE SERVICES
  • Facility Address: 649 SOUTE AVE, SUITE 8
    SECANE, PA
    ZIP 19018
  • Facility Phone: 484 278-4805
  • Facility Type: Home Health Agency
  • Facility Type: Waiver
  • Lab Director: NURAT O. OLUKANNI RN
  • NPI Number: 1164859500
  • Taxonomy: 251E00000X - Home Health

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CLIA Record

Field Name Field Value
CLIA Number 39D2073185
LAB Type Home Health Agency
Facility Name MOG HOME HEALTH CARE SERVICES
Street 649 SOUTE AVE, SUITE 8
City SECANE
State PA
ZIP 19018
Phone 484 278-4805
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 2/12/2024
Certificate Expiration Date 2/11/2026
Facility Type Home Health Agency
Lab Director NURAT O. OLUKANNI RN

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