39D2167916 CLIA NUMBER - CEDAR GROVE DIALYSIS

Laboratory Demographics

  • CLIA Code: 39D2167916
  • Facility Name: CEDAR GROVE DIALYSIS
  • Facility Address: 4952 PARKSIDE AVE
    PHILADELPHIA, PA
    ZIP 19131
  • Facility Phone: (215) 871-0810
  • Facility Type: End Stage Renal Disease Dialysis Facility
  • Facility Type: Waiver
  • Lab Director: DR. SIDDHARTH P. SHAH
  • NPI Number: 1023185147
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 39D2167916
LAB Type End Stage Renal Disease Dialysis Facility
Facility Name CEDAR GROVE DIALYSIS
Street 4952 PARKSIDE AVE
City PHILADELPHIA
State PA
ZIP 19131
Phone 2158710810
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 6/18/2025
Certificate Expiration Date 6/17/2027
Facility Type End Stage Renal Disease Dialysis Facility
Lab Director DR. SIDDHARTH P. SHAH

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This page was last updated on: 5/18/2026