36D1076341 CLIA NUMBER - TOLEDO CLINIC DR DURRANI

Laboratory Demographics

CLIA Number: 36D1076341

Facility Name: TOLEDO CLINIC DR DURRANI

Facility Address:
4646 NANTUCKETT DRIVE STE C
TOLEDO, OH
ZIP 43623
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Facility Phone Number: 419 720-7676

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1700842796

Taxonomy: 363AM0700X - Physician Assistant

CLIA Record

Field Name	Field Value
CLIA Number	36D1076341
LAB Type	Physician Office
Facility Name	TOLEDO CLINIC DR DURRANI
Street	4646 NANTUCKETT DRIVE STE C
City	TOLEDO
State	OH
ZIP	43623
Phone	419 720-7676
CertificateType	4
CertificateEffectiveDate	11/13/2023
CertificateExpirationDate	11/12/2025
FacilityType	Waiver

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