36D0701796 CLIA NUMBER - JACKSON FAMILY PRACTICE

Laboratory Demographics

CLIA Number: 36D0701796

Facility Name: JACKSON FAMILY PRACTICE

Facility Address:
7072 MEARS GATE DRIVE NW
NORTH CANTON, OH
ZIP 44720
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Facility Phone Number: 330 966-1319

Facility Type: Physician Office

Certificate Type: Microscopy

NPI Number: 1699881581

Taxonomy: 207Q00000X - Family Medicine
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.

CLIA Record

Field Name	Field Value
CLIA Number	36D0701796
LAB Type	Physician Office
Facility Name	JACKSON FAMILY PRACTICE
Street	7072 MEARS GATE DRIVE NW
City	NORTH CANTON
State	OH
ZIP	44720
Phone	330 966-1319
CertificateType	3
CertificateEffectiveDate	4/22/2024
CertificateExpirationDate	4/21/2026
FacilityType	PPMP

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