36D1035830 CLIA NUMBER - PHOENIX DERMATOLOGY

Laboratory Demographics

  • CLIA Code: 36D1035830
  • Facility Name: PHOENIX DERMATOLOGY
  • Facility Address: 4340 FULTON ROAD
    CANTON, OH
    ZIP 44718
  • Facility Phone: 330 832-6831
  • Facility Type: Physician Office
  • Facility Type: Microscopy
  • Lab Director: MARIA A. CHARIF MD
  • NPI Number: 1285697060
  • Taxonomy: 174400000X - Specialist

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CLIA Record

Field Name Field Value
CLIA Number 36D1035830
LAB Type Physician Office
Facility Name PHOENIX DERMATOLOGY
Street 4340 FULTON ROAD
City CANTON
State OH
ZIP 44718
Phone 330 832-6831
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 1/12/2025
Certificate Expiration Date 1/11/2027
Facility Type Physician Office
Lab Director MARIA A. CHARIF MD

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