39D2312798 CLIA NUMBER - NOSTALGIC EYE CARE

Laboratory Demographics

  • CLIA Code: 39D2312798
  • Facility Name: NOSTALGIC EYE CARE
  • Facility Address: 6656 GERMANTOWN AVE
    PHILADELPHIA, PA
    ZIP 19119
  • Facility Phone: 215 842-5939
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: DR. KENNARD L. HERRING
  • NPI Number: 1417300849
  • Taxonomy: 261QH0100X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 39D2312798
LAB Type Physician Office
Facility Name NOSTALGIC EYE CARE
Street 6656 GERMANTOWN AVE
City PHILADELPHIA
State PA
ZIP 19119
Phone 215 842-5939
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/18/2024
Certificate Expiration Date 10/17/2026
Facility Type Physician Office
Lab Director DR. KENNARD L. HERRING

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