36D0923236 CLIA NUMBER - AMG ENDOCRINOLOGY

Laboratory Demographics

  • CLIA Code: 36D0923236
  • Facility Name: AMG ENDOCRINOLOGY
  • Facility Address: 4634 HILLS AND DALES ROAD NW
    CANTON, OH
    ZIP 44708
  • Facility Phone: 330 477-0255
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: KEVIN G. WIETECHA
  • NPI Number: 1255434494
  • Taxonomy: 207RE0101X - Internal Medicine

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CLIA Record

Field Name Field Value
CLIA Number 36D0923236
LAB Type Physician Office
Facility Name AMG ENDOCRINOLOGY
Street 4634 HILLS AND DALES ROAD NW
City CANTON
State OH
ZIP 44708
Phone 330 477-0255
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 12/18/2024
Certificate Expiration Date 12/17/2026
Facility Type Physician Office
Lab Director KEVIN G. WIETECHA

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