36D1053945 CLIA NUMBER - MAUMEE HEALTH AND WELLNESS

Laboratory Demographics

  • CLIA Code: 36D1053945
  • Facility Name: MAUMEE HEALTH AND WELLNESS
  • Facility Address: 3355 BRIARFIELD BLVD SUITE E
    MAUMEE, OH
    ZIP 43537
  • Facility Phone: 419 868-3788
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: KRISHNA M. RAGOTHAMAN MD
  • NPI Number: 1558535807
  • Taxonomy: 208D00000X - General Practice

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CLIA Record

Field Name Field Value
CLIA Number 36D1053945
LAB Type Physician Office
Facility Name MAUMEE HEALTH AND WELLNESS
Street 3355 BRIARFIELD BLVD SUITE E
City MAUMEE
State OH
ZIP 43537
Phone 419 868-3788
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 5/9/2024
Certificate Expiration Date 5/8/2026
Facility Type Physician Office
Lab Director KRISHNA M. RAGOTHAMAN MD

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