36D0960788 CLIA NUMBER - WESTSIDE GASTROENTEROLOGY SOUTHWEST GENERAL HOSPITAL

Laboratory Demographics

  • CLIA Code: 36D0960788
  • Facility Name: WESTSIDE GASTROENTEROLOGY SOUTHWEST GENERAL HOSPITAL
  • Facility Address: 18780 BAGLEY ROAD SUITE 200
    MIDDLEBURG HEIGHTS, OH
    ZIP 44130
  • Facility Phone: 440 816-4546
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: NITIN DAVESSAR
  • NPI Number: 1285767673
  • Taxonomy: 207RG0100X - Internal Medicine

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CLIA Record

Field Name Field Value
CLIA Number 36D0960788
LAB Type Physician Office
Facility Name WESTSIDE GASTROENTEROLOGY SOUTHWEST GENERAL HOSPITAL
Street 18780 BAGLEY ROAD SUITE 200
City MIDDLEBURG HEIGHTS
State OH
ZIP 44130
Phone 440 816-4546
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 7/2/2024
Certificate Expiration Date 7/1/2026
Facility Type Physician Office
Lab Director NITIN DAVESSAR

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