39D2242278 CLIA NUMBER - PELHAM PHARMACY

Laboratory Demographics

  • CLIA Code: 39D2242278
  • Facility Name: PELHAM PHARMACY
  • Facility Address: 6555 GREENE ST, SUITE #3
    PHILADELPHIA, PA
    ZIP 19119
  • Facility Phone: 215 848-0500
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: IDAYAT A. ADEWUNMI
  • NPI Number: 1083994925
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 39D2242278
LAB Type Pharmacy
Facility Name PELHAM PHARMACY
Street 6555 GREENE ST, SUITE #3
City PHILADELPHIA
State PA
ZIP 19119
Phone 215 848-0500
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 11/6/2023
Certificate Expiration Date 11/5/2025
Facility Type Pharmacy
Lab Director IDAYAT A. ADEWUNMI

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