36D0982273 CLIA NUMBER - PREMIER CARE PEDIATRICS

Laboratory Demographics

  • CLIA Code: 36D0982273
  • Facility Name: PREMIER CARE PEDIATRICS
  • Facility Address: 2642 STATE ROUTE 5
    CORTLAND, OH
    ZIP 44410
  • Facility Phone: 330 841-5500
  • Facility Type: Federally Qualified Health Center
  • Facility Type: Waiver
  • Lab Director: RONALD DWINNELLS
  • NPI Number: 1508942400
  • Taxonomy: 208000000X - Pediatrics

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CLIA Record

Field Name Field Value
CLIA Number 36D0982273
LAB Type Federally Qualified Health Center
Facility Name PREMIER CARE PEDIATRICS
Street 2642 STATE ROUTE 5
City CORTLAND
State OH
ZIP 44410
Phone 330 841-5500
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 1/22/2025
Certificate Expiration Date 1/21/2027
Facility Type Federally Qualified Health Center
Lab Director RONALD DWINNELLS

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