36D0966020 CLIA NUMBER - NORTHWEST OB-GYN

Laboratory Demographics

  • CLIA Code: 36D0966020
  • Facility Name: NORTHWEST OB-GYN
  • Facility Address: 133 S HICKORY STREET
    OTTAWA, OH
    ZIP 45875
  • Facility Phone: 419 358-8856
  • Facility Type: Physician Office
  • Facility Type: Microscopy
  • Lab Director: DESRENE BROWN
  • NPI Number: 1487687125
  • Taxonomy: 225100000X - Physical Therapist

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CLIA Record

Field Name Field Value
CLIA Number 36D0966020
LAB Type Physician Office
Facility Name NORTHWEST OB-GYN
Street 133 S HICKORY STREET
City OTTAWA
State OH
ZIP 45875
Phone 419 358-8856
Certificate Type Certificate for Provider-Performed Microscopy Procedures (PPMP)
Certificate Type Description This certificate is issued to a laboratory in which a physician, midlevel practitioner or dentist performs no tests other than the microscopy procedures. This certificate permits the laboratory to also perform waived tests.
Certificate Effective Date 10/6/2025
Certificate Expiration Date 10/5/2027
Facility Type Physician Office
Lab Director DESRENE BROWN

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