39D2258393 CLIA NUMBER - IMPACTFUL CARE LLC

Laboratory Demographics

  • CLIA Code: 39D2258393
  • Facility Name: IMPACTFUL CARE LLC
  • Facility Address: 18 CAMPUS BOULEVARD SUITE 100
    NEWTOWN SQUARE, PA
    ZIP 19073
  • Facility Phone: 215 995-5209
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: DR. RUPPERT A. HAWES
  • NPI Number: 1821845249
  • Taxonomy: 261Q00000X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 39D2258393
LAB Type Physician Office
Facility Name IMPACTFUL CARE LLC
Street 18 CAMPUS BOULEVARD SUITE 100
City NEWTOWN SQUARE
State PA
ZIP 19073
Phone 215 995-5209
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/21/2024
Certificate Expiration Date 4/20/2026
Facility Type Physician Office
Lab Director DR. RUPPERT A. HAWES

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