CLIA lab
CLIA 39D0202602: Immaculate Mary Home
Philadelphia, PA. Certificate and address details from the CMS Provider of Services file for clinical laboratories.
CLIA number 39D0202602 belongs to Immaculate Mary Home in Philadelphia, PA.
Certificate of Waiver, effective September 1, 2026, expires August 31, 2028.
Active in the CMS Provider of Services file posted October 16, 2026.
Source: CMS Provider of Services File, Clinical Laboratories (CLIA), as of October 16, 2026. Publisher page
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Certificate
- Certificate type
- Certificate of Waiver
- Certificate effective
- September 1, 2026
- Certificate expiration
- August 31, 2028
- Status in the CMS file
- Active (termination code 00)
- Original participation date
- December 29, 1992
- Facility type
- Skilled nursing or nursing facility
- Ownership (control type)
- Religious affiliation
- Lab classification
- CLIA laboratory
Source: CMS Provider of Services File, Clinical Laboratories (CLIA), as of October 16, 2026. Publisher page
Lab and contact
- CLIA number
- 39D0202602
- Lab name
- Immaculate Mary Home
- Address
- 2990 Holme Avenue, Philadelphia, PA 19136
- Phone
- (215) 992-1824
- Fax
- (215) 335-4036
Annual test volume the lab reported
- Waived tests
- 3,825
Volumes are what the lab reported to CMS on its CMS-116 application, as carried in the file.
Care facility at this address
- Immaculatemarycenter for Rehabilitation&healthcareCMS Care Compare ratings for the facility at the same street address
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Questions
What is the CLIA number for Immaculate Mary Home in Philadelphia?
39D0202602, per the CMS Provider of Services file posted October 16, 2026.
What CLIA certificate does Immaculate Mary Home hold?
A Certificate of Waiver, according to the CMS file.
When does CLIA 39D0202602 expire?
The CMS file lists August 31, 2028 as the certificate expiration date; the certificate took effect September 1, 2026.