36D1027349 CLIA NUMBER - STARK AMBULATORY SURGERY CENTER LLC

Laboratory Demographics

  • CLIA Code: 36D1027349
  • Facility Name: STARK AMBULATORY SURGERY CENTER LLC
  • Facility Address: 4360 FULTON DRIVE NW SUITE C
    CANTON, OH
    ZIP 44718
  • Facility Phone: 330 305-0303
  • Facility Type: Ambulatory Surgery Center
  • Facility Type: Waiver
  • Lab Director: NABIL FAHMY
  • NPI Number: 1740260926
  • Taxonomy: 261QA1903X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 36D1027349
LAB Type Ambulatory Surgery Center
Facility Name STARK AMBULATORY SURGERY CENTER LLC
Street 4360 FULTON DRIVE NW SUITE C
City CANTON
State OH
ZIP 44718
Phone 330 305-0303
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 6/28/2024
Certificate Expiration Date 6/27/2026
Facility Type Ambulatory Surgery Center
Lab Director NABIL FAHMY

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