39D0204097 CLIA NUMBER - PENNRIDGE PEDIATRIC

Laboratory Demographics

  • CLIA Code: 39D0204097
  • Facility Name: PENNRIDGE PEDIATRIC
  • Facility Address: 270 MAIN STREET
    HARLEYSVILLE, PA
    ZIP 19438
  • Facility Phone: 215 256-1999
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: DR. DEBORAH R. FACCENDA MD
  • NPI Number: 1205009388
  • Taxonomy: 208600000X - Surgery

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CLIA Record

Field Name Field Value
CLIA Number 39D0204097
LAB Type Physician Office
Facility Name PENNRIDGE PEDIATRIC
Street 270 MAIN STREET
City HARLEYSVILLE
State PA
ZIP 19438
Phone 215 256-1999
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/30/2024
Certificate Expiration Date 8/29/2026
Facility Type Physician Office
Lab Director DR. DEBORAH R. FACCENDA MD

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This page was last updated on: 6/4/2025