36D0344213 CLIA NUMBER - EXECUTIVE UROLOGY OF FISHER-TITUS SANDUSKY

Laboratory Demographics

  • CLIA Code: 36D0344213
  • Facility Name: EXECUTIVE UROLOGY OF FISHER-TITUS SANDUSKY
  • Facility Address: 2800 HAYES AVE BLDG D
    SANDUSKY, OH
    ZIP 44870
  • Facility Phone: 419 627-8771
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: DR. GREGORY COOK
  • NPI Number: 1649594318
  • Taxonomy: 208800000X - Urology

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CLIA Record

Field Name Field Value
CLIA Number 36D0344213
LAB Type Physician Office
Facility Name EXECUTIVE UROLOGY OF FISHER-TITUS SANDUSKY
Street 2800 HAYES AVE BLDG D
City SANDUSKY
State OH
ZIP 44870
Phone 419 627-8771
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/29/2023
Certificate Expiration Date 10/28/2025
Facility Type Physician Office
Lab Director DR. GREGORY COOK

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