36D2028168 CLIA NUMBER - OHIO PREMIER DERMATOLOGY LLC

Laboratory Demographics

  • CLIA Code: 36D2028168
  • Facility Name: OHIO PREMIER DERMATOLOGY LLC
  • Facility Address: 44 SOUTH KINTNER PARKWAY SUITE B
    SUNBURY, OH
    ZIP 43074
  • Facility Phone: 740 965-0855
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: RAMONA M. SARSAMA NIXON
  • NPI Number: 1316233158
  • Taxonomy: 207N00000X - Dermatology

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CLIA Record

Field Name Field Value
CLIA Number 36D2028168
LAB Type Physician Office
Facility Name OHIO PREMIER DERMATOLOGY LLC
Street 44 SOUTH KINTNER PARKWAY SUITE B
City SUNBURY
State OH
ZIP 43074
Phone 740 965-0855
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/22/2024
Certificate Expiration Date 3/21/2026
Facility Type Physician Office
Lab Director RAMONA M. SARSAMA NIXON

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