39D2273423 CLIA NUMBER - COTTMAN AVENUE HEALTH CENTER

Laboratory Demographics

  • CLIA Code: 39D2273423
  • Facility Name: COTTMAN AVENUE HEALTH CENTER
  • Facility Address: 3525-27 COTTMAN AVENUE
    PHILADELPHIA, PA
    ZIP 19149
  • Facility Phone: 215 471-5761
  • Facility Type: Federally Qualified Health Center
  • Facility Type: Microscopy
  • Lab Director: DR. JOANNE C. BRICE
  • NPI Number: 1336878040
  • Taxonomy: 261QF0400X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 39D2273423
LAB Type Federally Qualified Health Center
Facility Name COTTMAN AVENUE HEALTH CENTER
Street 3525-27 COTTMAN AVENUE
City PHILADELPHIA
State PA
ZIP 19149
Phone 215 471-5761
Certificate Type Certificate for Provider-Performed Microscopy Procedures (PPMP)
Certificate Type Description This certificate is issued to a laboratory in which a physician, midlevel practitioner or dentist performs no tests other than the microscopy procedures. This certificate permits the laboratory to also perform waived tests.
Certificate Effective Date 12/13/2024
Certificate Expiration Date 12/12/2026
Facility Type Federally Qualified Health Center
Lab Director DR. JOANNE C. BRICE

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