36D0331887 CLIA NUMBER - PROMEDICA PHYSICIANS TOLEDO PEDS

Laboratory Demographics

  • CLIA Code: 36D0331887
  • Facility Name: PROMEDICA PHYSICIANS TOLEDO PEDS
  • Facility Address: 5700 MONROE STREET SUITE 301
    SYLVANIA, OH
    ZIP 43560
  • Facility Phone: 419 291-2849
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: ALAN BURLINGAME
  • NPI Number: 1629119821
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 36D0331887
LAB Type Physician Office
Facility Name PROMEDICA PHYSICIANS TOLEDO PEDS
Street 5700 MONROE STREET SUITE 301
City SYLVANIA
State OH
ZIP 43560
Phone 419 291-2849
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/10/2024
Certificate Expiration Date 8/9/2026
Facility Type Physician Office
Lab Director ALAN BURLINGAME

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