39D2299999 CLIA NUMBER - MEDEX URGENT CARE

Laboratory Demographics

  • CLIA Code: 39D2299999
  • Facility Name: MEDEX URGENT CARE
  • Facility Address: 15200 BUSTLETON AVENUE
    PHILADELPHIA, PA
    ZIP 19116
  • Facility Phone: 215 971-4440
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: DR. DANIEL KOGAN
  • NPI Number: 1629855648
  • Taxonomy: 261QU0200X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 39D2299999
LAB Type Physician Office
Facility Name MEDEX URGENT CARE
Street 15200 BUSTLETON AVENUE
City PHILADELPHIA
State PA
ZIP 19116
Phone 215 971-4440
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/1/2024
Certificate Expiration Date 2/28/2026
Facility Type Physician Office
Lab Director DR. DANIEL KOGAN

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