36D0672659 CLIA NUMBER - PROGRESSIVE HEALTH SERVICES CAMPUS 1

Laboratory Demographics

CLIA Number: 36D0672659

Facility Name: PROGRESSIVE HEALTH SERVICES CAMPUS 1

Facility Address:
6300 WILSON MILLS ROAD
MAYFIELD VILLAGE, OH
ZIP 44143
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Facility Phone Number: 440 910-7662

Facility Type: Insurance

Certificate Type: Microscopy

NPI Number: 1447491410

Taxonomy: 261QP2300X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	36D0672659
LAB Type	Insurance
Facility Name	PROGRESSIVE HEALTH SERVICES CAMPUS 1
Street	6300 WILSON MILLS ROAD
City	MAYFIELD VILLAGE
State	OH
ZIP	44143
Phone	440 910-7662
CertificateType	3
CertificateEffectiveDate	9/13/2022
CertificateExpirationDate	9/12/2024
FacilityType	PPMP

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