36D0933149 CLIA NUMBER - PREMIER PHYSICIANS CENTER

Laboratory Demographics

  • CLIA Code: 36D0933149
  • Facility Name: PREMIER PHYSICIANS CENTER
  • Facility Address: 15644 MADISON AVENUE ROOM 101
    LAKEWOOD, OH
    ZIP 44107
  • Facility Phone: 216 228-6565
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: DR. MOHAMAD S. KALASH
  • NPI Number: 1073552329
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 36D0933149
LAB Type Physician Office
Facility Name PREMIER PHYSICIANS CENTER
Street 15644 MADISON AVENUE ROOM 101
City LAKEWOOD
State OH
ZIP 44107
Phone 216 228-6565
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/8/2025
Certificate Expiration Date 9/7/2027
Facility Type Physician Office
Lab Director DR. MOHAMAD S. KALASH

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