39D2098197 CLIA NUMBER - MY DOC URGENT CARE

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Laboratory Demographics

CLIA Number: 39D2098197

Facility Name: MY DOC URGENT CARE

Facility Address:
1420 LOCUST ST R1A
PHILADELPHIA, PA
ZIP 19102
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Facility Phone Number: 215 815-4650

Facility Type: Other - URGENT CARE

Certificate Type: Waiver

NPI Number: 1689067472

Taxonomy: 261QU0200X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	39D2098197
LAB Type	Other - URGENT CARE
Facility Name	MY DOC URGENT CARE
Street	1420 LOCUST ST R1A
City	PHILADELPHIA
State	PA
ZIP	19102
Phone	215 815-4650
CertificateType	4
CertificateEffectiveDate	10/24/2022
CertificateExpirationDate	10/23/2024
FacilityType	Waiver

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