39D2301284 CLIA NUMBER - ELWYN ABH-PRESTON

Laboratory Demographics

  • CLIA Code: 39D2301284
  • Facility Name: ELWYN ABH-PRESTON
  • Facility Address: 12 N PRESTON ST
    PHILADELPHIA, PA
    ZIP 19104
  • Facility Phone: 610 891-2400
  • Facility Type: Community Clinic
  • Facility Type: Waiver
  • Lab Director: DR. MICHELE SHRIKANTHAN
  • NPI Number: 1396995411
  • Taxonomy: 252Y00000X - Early Intervention Provider Agency

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CLIA Record

Field Name Field Value
CLIA Number 39D2301284
LAB Type Community Clinic
Facility Name ELWYN ABH-PRESTON
Street 12 N PRESTON ST
City PHILADELPHIA
State PA
ZIP 19104
Phone 610 891-2400
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/25/2024
Certificate Expiration Date 3/24/2026
Facility Type Community Clinic
Lab Director DR. MICHELE SHRIKANTHAN

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