36D0965795 CLIA NUMBER - GEORGE G ELLIS JR, MD

Laboratory Demographics

  • CLIA Code: 36D0965795
  • Facility Name: GEORGE G ELLIS JR, MD
  • Facility Address: 910 BOARDMAN-CANFIELD RD, SUITE A
    YOUNGSTOWN, OH
    ZIP 44512
  • Facility Phone: (330) 965-0832
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: GEORGE G. ELLIS JR
  • NPI Number: 1366428484
  • Taxonomy: 207R00000X - Internal Medicine

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CLIA Record

Field Name Field Value
CLIA Number 36D0965795
LAB Type Physician Office
Facility Name GEORGE G ELLIS JR, MD
Street 910 BOARDMAN-CANFIELD RD, SUITE A
City YOUNGSTOWN
State OH
ZIP 44512
Phone 3309650832
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/29/2025
Certificate Expiration Date 9/28/2027
Facility Type Physician Office
Lab Director GEORGE G. ELLIS JR

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This page was last updated on: 5/18/2026