36D0720756 CLIA NUMBER - STEVEN P JACKSON DO

Laboratory Demographics

  • CLIA Code: 36D0720756
  • Facility Name: STEVEN P JACKSON DO
  • Facility Address: 1297 W MAIN ST
    MARBLEHEAD, OH
    ZIP 43440
  • Facility Phone: 419 798-4418
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: STEVEN P. JACKSON DO
  • NPI Number: 1265527865
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 36D0720756
LAB Type Physician Office
Facility Name STEVEN P JACKSON DO
Street 1297 W MAIN ST
City MARBLEHEAD
State OH
ZIP 43440
Phone 419 798-4418
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/1/2024
Certificate Expiration Date 8/31/2026
Facility Type Physician Office
Lab Director STEVEN P. JACKSON DO

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