36D0939206 CLIA NUMBER - HUDSON FAMILY PRACTICE INC

Laboratory Demographics

  • CLIA Code: 36D0939206
  • Facility Name: HUDSON FAMILY PRACTICE INC
  • Facility Address: 5655 HUDSON DR SUITE 303
    HUDSON, OH
    ZIP 44236
  • Facility Phone: 330 800-4800
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: TERRY J. WAGNER
  • NPI Number: 1063553980
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 36D0939206
LAB Type Physician Office
Facility Name HUDSON FAMILY PRACTICE INC
Street 5655 HUDSON DR SUITE 303
City HUDSON
State OH
ZIP 44236
Phone 330 800-4800
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/5/2025
Certificate Expiration Date 9/4/2027
Facility Type Physician Office
Lab Director TERRY J. WAGNER

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