39D2106377 CLIA NUMBER - BROWN STREET DIALYSIS

Laboratory Demographics

  • CLIA Code: 39D2106377
  • Facility Name: BROWN STREET DIALYSIS
  • Facility Address: 4800 BROWN STREET, SUITE 201
    PHILADELPHIA, PA
    ZIP 19139
  • Facility Phone: 215 581-4993
  • Facility Type: End Stage Renal Disease Dialysis Facility
  • Facility Type: Waiver
  • Lab Director: DR. MARIE B. LIM
  • NPI Number: 1417566621
  • Taxonomy: 261QE0700X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 39D2106377
LAB Type End Stage Renal Disease Dialysis Facility
Facility Name BROWN STREET DIALYSIS
Street 4800 BROWN STREET, SUITE 201
City PHILADELPHIA
State PA
ZIP 19139
Phone 215 581-4993
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 12/17/2023
Certificate Expiration Date 12/16/2025
Facility Type End Stage Renal Disease Dialysis Facility
Lab Director DR. MARIE B. LIM

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