36D0969409 CLIA NUMBER - UNIVERSITY HOSPITALS MENTOR SURGERY CENTER

Laboratory Demographics

  • CLIA Code: 36D0969409
  • Facility Name: UNIVERSITY HOSPITALS MENTOR SURGERY CENTER
  • Facility Address: 9000 MENTOR AVENUE SUITE 220
    MENTOR, OH
    ZIP 44060
  • Facility Phone: 440 205-4505
  • Facility Type: Ambulatory Surgery Center
  • Facility Type: Waiver
  • Lab Director: GIRISH MULGAOKAR MD
  • NPI Number: 1053405217
  • Taxonomy: 332B00000X - Durable Medical Equipment & Medical Supplies

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CLIA Record

Field Name Field Value
CLIA Number 36D0969409
LAB Type Ambulatory Surgery Center
Facility Name UNIVERSITY HOSPITALS MENTOR SURGERY CENTER
Street 9000 MENTOR AVENUE SUITE 220
City MENTOR
State OH
ZIP 44060
Phone 440 205-4505
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 1/13/2024
Certificate Expiration Date 1/12/2026
Facility Type Ambulatory Surgery Center
Lab Director GIRISH MULGAOKAR MD

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