36D0965882 CLIA NUMBER - DISCOUNT DRUG MART #17

Laboratory Demographics

  • CLIA Code: 36D0965882
  • Facility Name: DISCOUNT DRUG MART #17
  • Facility Address: 4170 FULTON ROAD
    CLEVELAND, OH
    ZIP 44144
  • Facility Phone: 216 741-3993
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: DAVID SVENSON
  • NPI Number: 1407892896
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 36D0965882
LAB Type Pharmacy
Facility Name DISCOUNT DRUG MART #17
Street 4170 FULTON ROAD
City CLEVELAND
State OH
ZIP 44144
Phone 216 741-3993
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 1/7/2024
Certificate Expiration Date 1/6/2026
Facility Type Pharmacy
Lab Director DAVID SVENSON

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