39D2138174 CLIA NUMBER - WISSAHICKON DIALYSIS

Laboratory Demographics

  • CLIA Code: 39D2138174
  • Facility Name: WISSAHICKON DIALYSIS
  • Facility Address: 235 W CHELTEN AVE
    PHILADELPHIA, PA
    ZIP 19144
  • Facility Phone: 215 844-0637
  • Facility Type: End Stage Renal Disease Dialysis Facility
  • Facility Type: Waiver
  • Lab Director: DR. MAURICIO A. PEDROZA
  • NPI Number: 1558484576
  • Taxonomy: 251300000X - Local Education Agency (LEA)

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CLIA Record

Field Name Field Value
CLIA Number 39D2138174
LAB Type End Stage Renal Disease Dialysis Facility
Facility Name WISSAHICKON DIALYSIS
Street 235 W CHELTEN AVE
City PHILADELPHIA
State PA
ZIP 19144
Phone 215 844-0637
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/12/2025
Certificate Expiration Date 10/11/2027
Facility Type End Stage Renal Disease Dialysis Facility
Lab Director DR. MAURICIO A. PEDROZA

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