36D1008176 CLIA NUMBER - MAPLE CITY FAMILY PRACTICE LLC

Laboratory Demographics

  • CLIA Code: 36D1008176
  • Facility Name: MAPLE CITY FAMILY PRACTICE LLC
  • Facility Address: 85 BENEDICT AVE, SUITE 101
    NORWALK, OH
    ZIP 44857
  • Facility Phone: 419 660-1717
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: KATHLEEN J. BURR
  • NPI Number: 1972959534
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 36D1008176
LAB Type Physician Office
Facility Name MAPLE CITY FAMILY PRACTICE LLC
Street 85 BENEDICT AVE, SUITE 101
City NORWALK
State OH
ZIP 44857
Phone 419 660-1717
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/23/2025
Certificate Expiration Date 4/22/2027
Facility Type Physician Office
Lab Director KATHLEEN J. BURR

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