36D1047747 CLIA NUMBER - JUSTIN P MIKULA MD INC

Laboratory Demographics

  • CLIA Code: 36D1047747
  • Facility Name: JUSTIN P MIKULA MD INC
  • Facility Address: 1615 NORTH RIVER ROAD NE SUITE 1
    WARREN, OH
    ZIP 44483
  • Facility Phone: 330 372-2333
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: JUSTIN P. MIKULA MD
  • NPI Number: 1750487542
  • Taxonomy: 207R00000X - Internal Medicine

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 36D1047747
LAB Type Physician Office
Facility Name JUSTIN P MIKULA MD INC
Street 1615 NORTH RIVER ROAD NE SUITE 1
City WARREN
State OH
ZIP 44483
Phone 330 372-2333
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 11/14/2023
Certificate Expiration Date 11/13/2025
Facility Type Physician Office
Lab Director JUSTIN P. MIKULA MD

Download Record

Download this CLIA record record in Text format: Export

Download this CLIA record record in Excel (CSV) format: Export

Download this CLIA record record in XML format: Export

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