39D2299985 CLIA NUMBER - JEFFERSON ENDOSCOPY CENTER CITY

Laboratory Demographics

CLIA Number: 39D2299985

Facility Name: JEFFERSON ENDOSCOPY CENTER CITY

Facility Address:
132 S 10TH ST 585 MAIN BLDG
PHILADELPHIA, PA
ZIP 19107
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Facility Phone Number: 215 955-8900

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1487030763

Taxonomy: 207RG0100X - Internal Medicine
An internist who specializes in diagnosis and treatment of diseases of the digestive organs including the stomach, bowels, liver and gallbladder. This specialist treats conditions such as abdominal pain, ulcers, diarrhea, cancer and jaundice and performs complex diagnostic and therapeutic procedures using endoscopes to visualize internal organs.

CLIA Record

Field Name	Field Value
CLIA Number	39D2299985
LAB Type	Physician Office
Facility Name	JEFFERSON ENDOSCOPY CENTER CITY
Street	132 S 10TH ST 585 MAIN BLDG
City	PHILADELPHIA
State	PA
ZIP	19107
Phone	215 955-8900
CertificateType	4
CertificateEffectiveDate	3/1/2024
CertificateExpirationDate	2/28/2026
FacilityType	Waiver

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This page was last updated on: 4/23/2024