39D2258796 CLIA NUMBER - TANG PHARMACY IV

Laboratory Demographics

  • CLIA Code: 39D2258796
  • Facility Name: TANG PHARMACY IV
  • Facility Address: 900 N BROAD STREET
    PHILADELPHIA, PA
    ZIP 19130
  • Facility Phone: 267 666-0026
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: XUANKHOA L. NGUYEN
  • NPI Number: 1790061547
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 39D2258796
LAB Type Pharmacy
Facility Name TANG PHARMACY IV
Street 900 N BROAD STREET
City PHILADELPHIA
State PA
ZIP 19130
Phone 267 666-0026
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/27/2024
Certificate Expiration Date 4/26/2026
Facility Type Pharmacy
Lab Director XUANKHOA L. NGUYEN

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