39D2222046 CLIA NUMBER - PROHEALTH ASSOCIATES

Laboratory Demographics

  • CLIA Code: 39D2222046
  • Facility Name: PROHEALTH ASSOCIATES
  • Facility Address: 9963 BUSTLETON AVE
    PHILADELPHIA, PA
    ZIP 19115
  • Facility Phone: 215 464-2753
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: DR. BLOSSOM JOY
  • NPI Number: 1518567106
  • Taxonomy: 363LF0000X - Nurse Practitioner

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CLIA Record

Field Name Field Value
CLIA Number 39D2222046
LAB Type Physician Office
Facility Name PROHEALTH ASSOCIATES
Street 9963 BUSTLETON AVE
City PHILADELPHIA
State PA
ZIP 19115
Phone 215 464-2753
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/27/2025
Certificate Expiration Date 4/26/2027
Facility Type Physician Office
Lab Director DR. BLOSSOM JOY

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