39D2174585 CLIA NUMBER - GLENN MILLER FAMILY MEDICINE

Laboratory Demographics

CLIA Number: 39D2174585

Facility Name: GLENN MILLER FAMILY MEDICINE

Facility Address:
700 FAYETTE ST
CONSHOHOCKEN, PA
ZIP 19428
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Facility Phone Number: 610 828-0358

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1487820163

Taxonomy: 207Q00000X - Family Medicine
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.

CLIA Record

Field Name	Field Value
CLIA Number	39D2174585
LAB Type	Physician Office
Facility Name	GLENN MILLER FAMILY MEDICINE
Street	700 FAYETTE ST
City	CONSHOHOCKEN
State	PA
ZIP	19428
Phone	610 828-0358
CertificateType	4
CertificateEffectiveDate	11/5/2023
CertificateExpirationDate	11/4/2025
FacilityType	Waiver

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