36D1058357 CLIA NUMBER - LHPG WILLOWICK PRIMARY CARE

Laboratory Demographics

  • CLIA Code: 36D1058357
  • Facility Name: LHPG WILLOWICK PRIMARY CARE
  • Facility Address: 29804 LAKESHORE BLVD
    WILLOWICK, OH
    ZIP 44095
  • Facility Phone: 440 602-6559
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: CHERRICA DAVIS
  • NPI Number: 1326141987
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 36D1058357
LAB Type Physician Office
Facility Name LHPG WILLOWICK PRIMARY CARE
Street 29804 LAKESHORE BLVD
City WILLOWICK
State OH
ZIP 44095
Phone 440 602-6559
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/5/2024
Certificate Expiration Date 9/4/2026
Facility Type Physician Office
Lab Director CHERRICA DAVIS

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