39D2094531 CLIA NUMBER - TEMPLE READY CARE- COTTMAN

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Laboratory Demographics

CLIA Number: 39D2094531

Facility Name: TEMPLE READY CARE- COTTMAN

Facility Address:
2118 COTTMAN AVENUE SUITE 2
PHILADELPHIA, PA
ZIP 19149
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Facility Phone Number: 215 926-9050

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1407254378

Taxonomy: 261QU0200X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	39D2094531
LAB Type	Physician Office
Facility Name	TEMPLE READY CARE- COTTMAN
Street	2118 COTTMAN AVENUE SUITE 2
City	PHILADELPHIA
State	PA
ZIP	19149
Phone	215 926-9050
CertificateType	4
CertificateEffectiveDate	4/20/2023
CertificateExpirationDate	4/19/2025
FacilityType	Waiver

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