36D1107832 CLIA NUMBER - MERCY HEALTH ST GEORGE PRIMARY CARE

Laboratory Demographics

  • CLIA Code: 36D1107832
  • Facility Name: MERCY HEALTH ST GEORGE PRIMARY CARE
  • Facility Address: 1254 YOUNGSTOWN WARREN ROAD SUITE 3A
    NILES, OH
    ZIP 44446
  • Facility Phone: 330 652-3000
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: HEBA L. MIKHAIL
  • NPI Number: 1366522583
  • Taxonomy: 207R00000X - Internal Medicine

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CLIA Record

Field Name Field Value
CLIA Number 36D1107832
LAB Type Physician Office
Facility Name MERCY HEALTH ST GEORGE PRIMARY CARE
Street 1254 YOUNGSTOWN WARREN ROAD SUITE 3A
City NILES
State OH
ZIP 44446
Phone 330 652-3000
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/15/2024
Certificate Expiration Date 8/14/2026
Facility Type Physician Office
Lab Director HEBA L. MIKHAIL

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