39D2176380 CLIA NUMBER - PEDIATRIC CARE GROUP PC

Laboratory Demographics

  • CLIA Code: 39D2176380
  • Facility Name: PEDIATRIC CARE GROUP PC
  • Facility Address: 890 2ND STREET PIKE, STE 904
    RICHBORO, PA
    ZIP 18954
  • Facility Phone: 215 515-8700
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: DR. MARIE C. KINSLEY
  • NPI Number: 1023652708
  • Taxonomy: 208000000X - Pediatrics

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CLIA Record

Field Name Field Value
CLIA Number 39D2176380
LAB Type Physician Office
Facility Name PEDIATRIC CARE GROUP PC
Street 890 2ND STREET PIKE, STE 904
City RICHBORO
State PA
ZIP 18954
Phone 215 515-8700
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 12/13/2023
Certificate Expiration Date 12/12/2025
Facility Type Physician Office
Lab Director DR. MARIE C. KINSLEY

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