39D2271304 CLIA NUMBER - CONCENTRA-KING OF PRUSSIA

Laboratory Demographics

  • CLIA Code: 39D2271304
  • Facility Name: CONCENTRA-KING OF PRUSSIA
  • Facility Address: 170 NORTH HENDERSON RD, SUITE 306
    KING OF PRUSSIA, PA
    ZIP 19406
  • Facility Phone: 610 337-1558
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: DR. THADDEUS D. DE HERRERA
  • NPI Number: 1144943242
  • Taxonomy: 261QX0100X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 39D2271304
LAB Type Physician Office
Facility Name CONCENTRA-KING OF PRUSSIA
Street 170 NORTH HENDERSON RD, SUITE 306
City KING OF PRUSSIA
State PA
ZIP 19406
Phone 610 337-1558
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 11/1/2024
Certificate Expiration Date 10/31/2026
Facility Type Physician Office
Lab Director DR. THADDEUS D. DE HERRERA

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