36D1036912 CLIA NUMBER - LICKING MEMORIAL DERMATOLOGY - DR BETHANY WYLES

Laboratory Demographics

  • CLIA Code: 36D1036912
  • Facility Name: LICKING MEMORIAL DERMATOLOGY - DR BETHANY WYLES
  • Facility Address: 687 HOPEWELL DRIVE, BUILDING #2
    HEATH, OH
    ZIP 43056
  • Facility Phone: (220) 564-1837
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: BETHANY A. WYLES

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CLIA Record

Field Name Field Value
CLIA Number 36D1036912
LAB Type Physician Office
Facility Name LICKING MEMORIAL DERMATOLOGY - DR BETHANY WYLES
Street 687 HOPEWELL DRIVE, BUILDING #2
City HEATH
State OH
ZIP 43056
Phone 2205641837
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/21/2025
Certificate Expiration Date 3/20/2027
Facility Type Physician Office
Lab Director BETHANY A. WYLES

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This page was last updated on: 5/18/2026