39D2151021 CLIA NUMBER - ABSOLUTECARE OF PHILADELPHIA, LLC

Laboratory Demographics

CLIA Number: 39D2151021

Facility Name: ABSOLUTECARE OF PHILADELPHIA, LLC

Facility Address:
1080 N DELAWARE AVENUE, SUITE 800
PHILADELPHIA, PA
ZIP 19125
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Facility Phone Number: 267 463-5800

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1437662772

Taxonomy: 261QP2300X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	39D2151021
LAB Type	Physician Office
Facility Name	ABSOLUTECARE OF PHILADELPHIA, LLC
Street	1080 N DELAWARE AVENUE, SUITE 800
City	PHILADELPHIA
State	PA
ZIP	19125
Phone	267 463-5800
CertificateType	4
CertificateEffectiveDate	7/10/2022
CertificateExpirationDate	7/9/2024
FacilityType	Waiver

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