36D0993559 CLIA NUMBER - OLD SCHOOLHOUSE FAMILY PRACTICE LLC

Laboratory Demographics

  • CLIA Code: 36D0993559
  • Facility Name: OLD SCHOOLHOUSE FAMILY PRACTICE LLC
  • Facility Address: 1955 LANCASTER NEWARK ROAD NE
    LANCASTER, OH
    ZIP 43130
  • Facility Phone: 740 689-2820
  • Facility Type: Physician Office
  • Facility Type: Microscopy
  • Lab Director: SANG KYUNE LEE
  • NPI Number: 1639351349
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 36D0993559
LAB Type Physician Office
Facility Name OLD SCHOOLHOUSE FAMILY PRACTICE LLC
Street 1955 LANCASTER NEWARK ROAD NE
City LANCASTER
State OH
ZIP 43130
Phone 740 689-2820
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 11/19/2023
Certificate Expiration Date 11/18/2025
Facility Type Physician Office
Lab Director SANG KYUNE LEE

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