36D0693042 CLIA NUMBER - PRIME HEALTH FAMILY PRACTICE

Laboratory Demographics

  • CLIA Code: 36D0693042
  • Facility Name: PRIME HEALTH FAMILY PRACTICE
  • Facility Address: 6270 NORTH RIDGE ROAD
    MADISON, OH
    ZIP 44057
  • Facility Phone: 440 428-8249
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: JULIA HENG MD
  • NPI Number: 1932143856
  • Taxonomy: 208000000X - Pediatrics

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CLIA Record

Field Name Field Value
CLIA Number 36D0693042
LAB Type Physician Office
Facility Name PRIME HEALTH FAMILY PRACTICE
Street 6270 NORTH RIDGE ROAD
City MADISON
State OH
ZIP 44057
Phone 440 428-8249
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/25/2024
Certificate Expiration Date 8/24/2026
Facility Type Physician Office
Lab Director JULIA HENG MD

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