39D2103084 CLIA NUMBER - PENNSYLVANIA OPTOMETRICS

Laboratory Demographics

  • CLIA Code: 39D2103084
  • Facility Name: PENNSYLVANIA OPTOMETRICS
  • Facility Address: 6778 FL-1 RIDGE AVENUE
    PHILADELPHIA, PA
    ZIP 19128
  • Facility Phone: 215 483-1636
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: DR. JEFFREY BROSOF
  • NPI Number: 1487190757
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 39D2103084
LAB Type Physician Office
Facility Name PENNSYLVANIA OPTOMETRICS
Street 6778 FL-1 RIDGE AVENUE
City PHILADELPHIA
State PA
ZIP 19128
Phone 215 483-1636
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/6/2025
Certificate Expiration Date 10/5/2027
Facility Type Physician Office
Lab Director DR. JEFFREY BROSOF

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