36D1068257 CLIA NUMBER - GREGORY J FACEMYER MD LLC DBA AUSTIN SQUARE MEDICAL GROUP

Laboratory Demographics

  • CLIA Code: 36D1068257
  • Facility Name: GREGORY J FACEMYER MD LLC DBA AUSTIN SQUARE MEDICAL GROUP
  • Facility Address: 5121 MAHONING AVENUE SECOND FLOOR
    YOUNGSTOWN, OH
    ZIP 44515
  • Facility Phone: 330 799-3223
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: GREGORY J. FACEMYER MD
  • NPI Number: 1710375894
  • Taxonomy: 207R00000X - Internal Medicine

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CLIA Record

Field Name Field Value
CLIA Number 36D1068257
LAB Type Physician Office
Facility Name GREGORY J FACEMYER MD LLC DBA AUSTIN SQUARE MEDICAL GROUP
Street 5121 MAHONING AVENUE SECOND FLOOR
City YOUNGSTOWN
State OH
ZIP 44515
Phone 330 799-3223
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 5/7/2025
Certificate Expiration Date 5/6/2027
Facility Type Physician Office
Lab Director GREGORY J. FACEMYER MD

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