36D0725683 CLIA NUMBER - SOUTH MAIN ST MEDICAL CENTER

Laboratory Demographics

  • CLIA Code: 36D0725683
  • Facility Name: SOUTH MAIN ST MEDICAL CENTER
  • Facility Address: 4880 SOUTH MAIN ST SUITE 4
    AKRON, OH
    ZIP 44319
  • Facility Phone: 234 271-3353
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: TODD LISY
  • NPI Number: 1194058446
  • Taxonomy: 207R00000X - Internal Medicine

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CLIA Record

Field Name Field Value
CLIA Number 36D0725683
LAB Type Physician Office
Facility Name SOUTH MAIN ST MEDICAL CENTER
Street 4880 SOUTH MAIN ST SUITE 4
City AKRON
State OH
ZIP 44319
Phone 234 271-3353
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 TODD LISY

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