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36D1062305 CLIA NUMBER - CUSTOM CARE MD

Laboratory Demographics

CLIA Number: 36D1062305

Facility Name: CUSTOM CARE MD

Facility Address:
1611 SOUTH GREEN ROAD SUITE 213
SOUTH EUCLID, OH
ZIP 44121
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Facility Phone Number: 216 382-8000

Facility Type: Physician Office

Certificate Type: Waiver
NPI Number: 1093904476

Taxonomy: 207R00000X - Internal Medicine
A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.

CLIA Record

Field Name Field Value
CLIA Number 36D1062305
LAB Type Physician Office
Facility Name CUSTOM CARE MD
Street 1611 SOUTH GREEN ROAD SUITE 213
City SOUTH EUCLID
State OH
ZIP 44121
Phone 216 382-8000
CertificateType 4
CertificateEffectiveDate 12/12/2022
CertificateExpirationDate 12/11/2024
FacilityType Waiver

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