39D2110422 CLIA NUMBER - JEFFERSON ENDOSCOPY CENTER AT BALA LLC

Laboratory Demographics

  • CLIA Code: 39D2110422
  • Facility Name: JEFFERSON ENDOSCOPY CENTER AT BALA LLC
  • Facility Address: 130 PRESIDENTIAL BLVD
    BALA CYNWYD, PA
    ZIP 19004
  • Facility Phone: 267 443-2040
  • Facility Type: Ambulatory Surgery Center
  • Facility Type: Waiver
  • Lab Director: DR. STEPHANIE M. MOLESKI
  • NPI Number: 1376932616
  • Taxonomy: 207R00000X - Internal Medicine

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CLIA Record

Field Name Field Value
CLIA Number 39D2110422
LAB Type Ambulatory Surgery Center
Facility Name JEFFERSON ENDOSCOPY CENTER AT BALA LLC
Street 130 PRESIDENTIAL BLVD
City BALA CYNWYD
State PA
ZIP 19004
Phone 267 443-2040
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/15/2024
Certificate Expiration Date 3/14/2026
Facility Type Ambulatory Surgery Center
Lab Director DR. STEPHANIE M. MOLESKI

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