39D2121951 CLIA NUMBER - FAIRMOUNT PRIMARY CARE CENTER AT GIRARD MED CTR

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Laboratory Demographics

CLIA Number: 39D2121951

Facility Name: FAIRMOUNT PRIMARY CARE CENTER AT GIRARD MED CTR

Facility Address:
820 W THOMPSON STREET
PHILADELPHIA, PA
ZIP 19122
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Facility Phone Number: (215) 599-4851

Facility Type: FEDERALLY QUALIFIED HEALTH CENTER

Certificate Type: Microscopy

NPI Number: 1538619333

Taxonomy: 261QF0400X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	39D2121951
LAB Type	FEDERALLY QUALIFIED HEALTH CENTER
Facility Name	FAIRMOUNT PRIMARY CARE CENTER AT GIRARD MED CTR
Street	820 W THOMPSON STREET
City	PHILADELPHIA
State	PA
ZIP	19122
Phone	(215) 599-4851

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This page was last updated on: 5/11/2023