39D2135926 CLIA NUMBER - ADVANCED DERMATOLOGY OF PENNSYLVANIA

Laboratory Demographics

CLIA Number: 39D2135926

Facility Name: ADVANCED DERMATOLOGY OF PENNSYLVANIA

Facility Address:
10159 VERREE ROAD
PHILADELPHIA, PA
ZIP 19116
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Facility Phone Number: 215 677-1155

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1669683256

Taxonomy: 207VG0400X - Obstetrics & Gynecology
A physician who specializes in diagnosis, treatment, and management of patients with gynecologic conditions. Source: National Uniform Claim Committee

CLIA Record

Field Name	Field Value
CLIA Number	39D2135926
LAB Type	Physician Office
Facility Name	ADVANCED DERMATOLOGY OF PENNSYLVANIA
Street	10159 VERREE ROAD
City	PHILADELPHIA
State	PA
ZIP	19116
Phone	215 677-1155
CertificateType	4
CertificateEffectiveDate	2/10/2023
CertificateExpirationDate	2/9/2025
FacilityType	Waiver

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