36D0331364 CLIA NUMBER - PROMEDICA PHYSICIANS ARROWHEAD PEDIATRICS

Laboratory Demographics

  • CLIA Code: 36D0331364
  • Facility Name: PROMEDICA PHYSICIANS ARROWHEAD PEDIATRICS
  • Facility Address: 660 BEAVER CREEK CIRCLE SUITE 100
    MAUMEE, OH
    ZIP 43537
  • Facility Phone: 419 891-6221
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: MELISSA MOORE
  • NPI Number: 1356485478
  • Taxonomy: 208000000X - Pediatrics

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CLIA Record

Field Name Field Value
CLIA Number 36D0331364
LAB Type Physician Office
Facility Name PROMEDICA PHYSICIANS ARROWHEAD PEDIATRICS
Street 660 BEAVER CREEK CIRCLE SUITE 100
City MAUMEE
State OH
ZIP 43537
Phone 419 891-6221
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/21/2025
Certificate Expiration Date 10/20/2027
Facility Type Physician Office
Lab Director MELISSA MOORE

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