36D0984437 CLIA NUMBER - ADA LIFE MEDICAL CENTER

Laboratory Demographics

  • CLIA Code: 36D0984437
  • Facility Name: ADA LIFE MEDICAL CENTER
  • Facility Address: 520 W LINCOLN AVE STE A
    ADA, OH
    ZIP 45810
  • Facility Phone: 419 634-2015
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: LAWRENCE KUK
  • NPI Number: 1225295835
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 36D0984437
LAB Type Physician Office
Facility Name ADA LIFE MEDICAL CENTER
Street 520 W LINCOLN AVE STE A
City ADA
State OH
ZIP 45810
Phone 419 634-2015
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/21/2025
Certificate Expiration Date 3/20/2027
Facility Type Physician Office
Lab Director LAWRENCE KUK

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