36D1049206 CLIA NUMBER - LEAHY FAMILY CARE INC

Laboratory Demographics

CLIA Number: 36D1049206

Facility Name: LEAHY FAMILY CARE INC

Facility Address:
825 SOUTH CABLE ROAD SUITE A
LIMA, OH
ZIP 45805
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Facility Phone Number: 419 224-1234

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1902918030

Taxonomy: 261QP2300X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	36D1049206
LAB Type	Physician Office
Facility Name	LEAHY FAMILY CARE INC
Street	825 SOUTH CABLE ROAD SUITE A
City	LIMA
State	OH
ZIP	45805
Phone	419 224-1234
CertificateType	4
CertificateEffectiveDate	12/28/2023
CertificateExpirationDate	12/27/2025
FacilityType	Waiver

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This page was last updated on: 4/23/2024