39D2242282 CLIA NUMBER - MERAKEY WOODHAVEN CENTER

Laboratory Demographics

CLIA Number: 39D2242282

Facility Name: MERAKEY WOODHAVEN CENTER

Facility Address:
2900 SOUTHAMPTON ROAD, HEALTH SERVICES - HOLLYOAK
PHILADELPHIA, PA
ZIP 19154
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Facility Phone Number: 215 704-5729

Facility Type: Intermediate Care Facility for Mentally Retarded

Certificate Type: Waiver

NPI Number: 1790908853

Taxonomy: 315P00000X - Intermediate Care Facility, Intellectual Disabilities
An intermediate care facility providing services for individuals with intellectual disabilities.

CLIA Record

Field Name	Field Value
CLIA Number	39D2242282
LAB Type	Intermediate Care Facility for Mentally Retarded
Facility Name	MERAKEY WOODHAVEN CENTER
Street	2900 SOUTHAMPTON ROAD, HEALTH SERVICES - HOLLYOAK
City	PHILADELPHIA
State	PA
ZIP	19154
Phone	215 704-5729
CertificateType	4
CertificateEffectiveDate	11/6/2023
CertificateExpirationDate	11/5/2025
FacilityType	Waiver

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