39D2157498 CLIA NUMBER - AIDS CARE GROUP ANNEX

Laboratory Demographics

  • CLIA Code: 39D2157498
  • Facility Name: AIDS CARE GROUP ANNEX
  • Facility Address: 2201 PROVIDENCE AVE
    CHESTER, PA
    ZIP 19013
  • Facility Phone: 610 872-9101
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: DR. GEETA M. VAZE
  • NPI Number: 1477592400
  • Taxonomy: 261Q00000X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 39D2157498
LAB Type Physician Office
Facility Name AIDS CARE GROUP ANNEX
Street 2201 PROVIDENCE AVE
City CHESTER
State PA
ZIP 19013
Phone 610 872-9101
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 11/7/2024
Certificate Expiration Date 11/6/2026
Facility Type Physician Office
Lab Director DR. GEETA M. VAZE

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