36D0969646 CLIA NUMBER - STARK MEDICAL SPECIALTIES, INC

Laboratory Demographics

  • CLIA Code: 36D0969646
  • Facility Name: STARK MEDICAL SPECIALTIES, INC
  • Facility Address: 2458 LINCOLN WAY EAST
    MASSILLON, OH
    ZIP 44646
  • Facility Phone: 330 837-1111
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: KERRIE L. DAVID
  • NPI Number: 1477573772
  • Taxonomy: 207R00000X - Internal Medicine

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CLIA Record

Field Name Field Value
CLIA Number 36D0969646
LAB Type Physician Office
Facility Name STARK MEDICAL SPECIALTIES, INC
Street 2458 LINCOLN WAY EAST
City MASSILLON
State OH
ZIP 44646
Phone 330 837-1111
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 1/21/2024
Certificate Expiration Date 1/20/2026
Facility Type Physician Office
Lab Director KERRIE L. DAVID

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This page was last updated on: 6/4/2025