36D0332625 CLIA NUMBER - PROMEDICA PHYSICIANS SUNFOREST OBSTETRICS/GYNECOLOGY

Laboratory Demographics

  • CLIA Code: 36D0332625
  • Facility Name: PROMEDICA PHYSICIANS SUNFOREST OBSTETRICS/GYNECOLOGY
  • Facility Address: 5700 MONROE STREET, SUITE 303
    SYLVANIA, OH
    ZIP 43560
  • Facility Phone: 419 473-6622
  • Facility Type: Physician Office
  • Facility Type: Microscopy
  • Lab Director: ALEXIS WAGGONER-NOSS
  • NPI Number: 1790826535
  • Taxonomy: 207V00000X - Obstetrics & Gynecology

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CLIA Record

Field Name Field Value
CLIA Number 36D0332625
LAB Type Physician Office
Facility Name PROMEDICA PHYSICIANS SUNFOREST OBSTETRICS/GYNECOLOGY
Street 5700 MONROE STREET, SUITE 303
City SYLVANIA
State OH
ZIP 43560
Phone 419 473-6622
Certificate Type Certificate for Provider-Performed Microscopy Procedures (PPMP)
Certificate Type Description This certificate is issued to a laboratory in which a physician, midlevel practitioner or dentist performs no tests other than the microscopy procedures. This certificate permits the laboratory to also perform waived tests.
Certificate Effective Date 2/5/2025
Certificate Expiration Date 2/4/2027
Facility Type Physician Office
Lab Director ALEXIS WAGGONER-NOSS

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