36D0335956 CLIA NUMBER - UHMG - BOLWELL FAMILY MEDICINE

Laboratory Demographics

CLIA Number: 36D0335956

Facility Name: UHMG - BOLWELL FAMILY MEDICINE

Facility Address:
11100 EUCLID AVENUE BOLWELL SUITE 1200
CLEVELAND, OH
ZIP 44106
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Facility Phone Number: 216 286-6296

Facility Type: Other - PHYSICIANS OFFICE NFP

Certificate Type: Microscopy

NPI Number: 1417011941

Taxonomy: 261QM1300X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	36D0335956
LAB Type	Other - PHYSICIANS OFFICE NFP
Facility Name	UHMG - BOLWELL FAMILY MEDICINE
Street	11100 EUCLID AVENUE BOLWELL SUITE 1200
City	CLEVELAND
State	OH
ZIP	44106
Phone	216 286-6296
CertificateType	3
CertificateEffectiveDate	12/22/2022
CertificateExpirationDate	12/21/2024
FacilityType	PPMP

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This page was last updated on: 4/23/2024