39D2221254 CLIA NUMBER - GAUDENZIA OUTREACH I OUTPATIENT SERVICES

Laboratory Demographics

  • CLIA Code: 39D2221254
  • Facility Name: GAUDENZIA OUTREACH I OUTPATIENT SERVICES
  • Facility Address: 1306 SPRING GARDEN STREET, 1ST FLOOR
    PHILADELPHIA, PA
    ZIP 19123
  • Facility Phone: 215 238-2150
  • Facility Type: Practitioner Other
  • Facility Type: Waiver
  • Lab Director: DR. NATHANIEL ABRAMSON
  • NPI Number: 1083743975
  • Taxonomy: 261QR0405X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 39D2221254
LAB Type Practitioner Other
Facility Name GAUDENZIA OUTREACH I OUTPATIENT SERVICES
Street 1306 SPRING GARDEN STREET, 1ST FLOOR
City PHILADELPHIA
State PA
ZIP 19123
Phone 215 238-2150
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/20/2025
Certificate Expiration Date 4/19/2027
Facility Type Practitioner Other
Lab Director DR. NATHANIEL ABRAMSON

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