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36D2001392 CLIA NUMBER - TIMOTHY E RYAN DO, LLC

Laboratory Demographics

CLIA Number: 36D2001392

Facility Name: TIMOTHY E RYAN DO, LLC

Facility Address:
4998 WEST BROAD STREET SUITE 102
COLUMBUS, OH
ZIP 43228
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Facility Phone Number: 614 878-7407

Facility Type: Physician Office

Certificate Type: Waiver
NPI Number: 1710480041

Taxonomy: 207YX0007X - Otolaryngology
An otolaryngologist with additional training in plastic and reconstructive procedures within the head, face, neck and associated structures, including cutaneous head and neck oncology and reconstruction, management of maxillofacial trauma, soft tissue repair and neural surgery. The field is diverse and involves a wide age range of patients, from the newborn to the aged. While both cosmetic and reconstructive surgeries are practiced, there are many additional procedures which interface with them.

CLIA Record

Field Name Field Value
CLIA Number 36D2001392
LAB Type Physician Office
Facility Name TIMOTHY E RYAN DO, LLC
Street 4998 WEST BROAD STREET SUITE 102
City COLUMBUS
State OH
ZIP 43228
Phone 614 878-7407
CertificateType 4
CertificateEffectiveDate 12/18/2023
CertificateExpirationDate 12/17/2025
FacilityType Waiver

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