39D2277522 CLIA NUMBER - MOMBA PHARMACY SERVICES LLC

Laboratory Demographics

  • CLIA Code: 39D2277522
  • Facility Name: MOMBA PHARMACY SERVICES LLC
  • Facility Address: 1435 SPRING GARDEN AVE
    PITTSBURGH, PA
    ZIP 15212
  • Facility Phone: 412 323-1801
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: FRED DEPASQUALE
  • NPI Number: 1386041655
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 39D2277522
LAB Type Pharmacy
Facility Name MOMBA PHARMACY SERVICES LLC
Street 1435 SPRING GARDEN AVE
City PITTSBURGH
State PA
ZIP 15212
Phone 412 323-1801
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/1/2025
Certificate Expiration Date 2/28/2027
Facility Type Pharmacy
Lab Director FRED DEPASQUALE

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