39D2081055 CLIA NUMBER - STEPHEN KLEIN WELLNESS CENTER

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Laboratory Demographics

CLIA Number: 39D2081055

Facility Name: STEPHEN KLEIN WELLNESS CENTER

Facility Address:
2144 CECIL B MOORE
PHILADELPHIA, PA
ZIP 19121
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Facility Phone Number: 215 320-6187

Facility Type: Federally Qualified Health Center

Certificate Type: Microscopy

NPI Number: 1609122506

Taxonomy: 261QF0400X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	39D2081055
LAB Type	Federally Qualified Health Center
Facility Name	STEPHEN KLEIN WELLNESS CENTER
Street	2144 CECIL B MOORE
City	PHILADELPHIA
State	PA
ZIP	19121
Phone	215 320-6187
CertificateType	3
CertificateEffectiveDate	7/18/2022
CertificateExpirationDate	7/17/2024
FacilityType	PPMP

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