36D0343547 CLIA NUMBER - MERIDIAN PEDIATRICS OF CANTON LLC

Laboratory Demographics

  • CLIA Code: 36D0343547
  • Facility Name: MERIDIAN PEDIATRICS OF CANTON LLC
  • Facility Address: 4188 HOLIDAY ST NW
    CANTON, OH
    ZIP 44718
  • Facility Phone: 330 492-6492
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: OTHELLO REPUYAN MD FAAP
  • NPI Number: 1801460860
  • Taxonomy: 208000000X - Pediatrics

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CLIA Record

Field Name Field Value
CLIA Number 36D0343547
LAB Type Physician Office
Facility Name MERIDIAN PEDIATRICS OF CANTON LLC
Street 4188 HOLIDAY ST NW
City CANTON
State OH
ZIP 44718
Phone 330 492-6492
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/1/2024
Certificate Expiration Date 8/31/2026
Facility Type Physician Office
Lab Director OTHELLO REPUYAN MD FAAP

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