36D0664432 CLIA NUMBER - UHMP - PEDIATRIC SERVICES - BRUNSWICK

Laboratory Demographics

  • CLIA Code: 36D0664432
  • Facility Name: UHMP - PEDIATRIC SERVICES - BRUNSWICK
  • Facility Address: 4065 CENTER ROAD SUITE 212
    BRUNSWICK, OH
    ZIP 44212
  • Facility Phone: 216 336-3822
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: DR. JULIA LIBECCO
  • NPI Number: 1184742223
  • Taxonomy: 208000000X - Pediatrics

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CLIA Record

Field Name Field Value
CLIA Number 36D0664432
LAB Type Physician Office
Facility Name UHMP - PEDIATRIC SERVICES - BRUNSWICK
Street 4065 CENTER ROAD SUITE 212
City BRUNSWICK
State OH
ZIP 44212
Phone 216 336-3822
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 2/1/2025
Certificate Expiration Date 1/31/2027
Facility Type Physician Office
Lab Director DR. JULIA LIBECCO

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This page was last updated on: 6/4/2025