39D2285678 CLIA NUMBER - BANNER CARE LLC

Laboratory Demographics

  • CLIA Code: 39D2285678
  • Facility Name: BANNER CARE LLC
  • Facility Address: 129 N 11TH ST, 1FL
    PHILADELPHIA, PA
    ZIP 19107
  • Facility Phone: 215 613-6273
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: DR. RAY A. ABARINTOS
  • NPI Number: 1558051961
  • Taxonomy: 208D00000X - General Practice

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CLIA Record

Field Name Field Value
CLIA Number 39D2285678
LAB Type Physician Office
Facility Name BANNER CARE LLC
Street 129 N 11TH ST, 1FL
City PHILADELPHIA
State PA
ZIP 19107
Phone 215 613-6273
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 7/17/2025
Certificate Expiration Date 7/16/2027
Facility Type Physician Office
Lab Director DR. RAY A. ABARINTOS

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