36D1031197 CLIA NUMBER - BEVERLY MEDICAL CENTER

Laboratory Demographics

  • CLIA Code: 36D1031197
  • Facility Name: BEVERLY MEDICAL CENTER
  • Facility Address: 531 5TH STREET
    BEVERLY, OH
    ZIP 45715
  • Facility Phone: 740 984-1414
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: ROBERT STUCKERT
  • NPI Number: 1962668665
  • Taxonomy: 207R00000X - Internal Medicine

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CLIA Record

Field Name Field Value
CLIA Number 36D1031197
LAB Type Physician Office
Facility Name BEVERLY MEDICAL CENTER
Street 531 5TH STREET
City BEVERLY
State OH
ZIP 45715
Phone 740 984-1414
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/27/2024
Certificate Expiration Date 9/26/2026
Facility Type Physician Office
Lab Director ROBERT STUCKERT

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