36D1048599 CLIA NUMBER - KENTON FAMILY PRACTICE LLC

Laboratory Demographics

  • CLIA Code: 36D1048599
  • Facility Name: KENTON FAMILY PRACTICE LLC
  • Facility Address: 75 WASHINGTON BLVD SUITE 101
    KENTON, OH
    ZIP 43326
  • Facility Phone: 419 675-1962
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: PAUL D. WESSON
  • NPI Number: 1083779110
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 36D1048599
LAB Type Physician Office
Facility Name KENTON FAMILY PRACTICE LLC
Street 75 WASHINGTON BLVD SUITE 101
City KENTON
State OH
ZIP 43326
Phone 419 675-1962
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 12/6/2023
Certificate Expiration Date 12/5/2025
Facility Type Physician Office
Lab Director PAUL D. WESSON

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