39D2149677 CLIA NUMBER - DEDICATED SENIOR MEDICAL CENTER MAYFAIR

Laboratory Demographics

  • CLIA Code: 39D2149677
  • Facility Name: DEDICATED SENIOR MEDICAL CENTER MAYFAIR
  • Facility Address: 6431 SACKETT STREET
    PHILADELPHIA, PA
    ZIP 19149
  • Facility Phone: 267 448-4908
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: DR. SUMIT KUMAR
  • NPI Number: 1477053569
  • Taxonomy: 174400000X - Specialist

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CLIA Record

Field Name Field Value
CLIA Number 39D2149677
LAB Type Physician Office
Facility Name DEDICATED SENIOR MEDICAL CENTER MAYFAIR
Street 6431 SACKETT STREET
City PHILADELPHIA
State PA
ZIP 19149
Phone 267 448-4908
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 6/8/2024
Certificate Expiration Date 6/7/2026
Facility Type Physician Office
Lab Director DR. SUMIT KUMAR

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