39D2149679 CLIA NUMBER - DEDICATED SENIOR MEDICAL CENTER WEST PHILADELPHIA

Laboratory Demographics

  • CLIA Code: 39D2149679
  • Facility Name: DEDICATED SENIOR MEDICAL CENTER WEST PHILADELPHIA
  • Facility Address: 1575 N 52ND STREET
    PHILADELPHIA, PA
    ZIP 19131
  • Facility Phone: 267 930-4858
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: DR. SUMIT KUMAR
  • NPI Number: 1609240217
  • Taxonomy: 251B00000X - Case Management

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CLIA Record

Field Name Field Value
CLIA Number 39D2149679
LAB Type Physician Office
Facility Name DEDICATED SENIOR MEDICAL CENTER WEST PHILADELPHIA
Street 1575 N 52ND STREET
City PHILADELPHIA
State PA
ZIP 19131
Phone 267 930-4858
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