36D2063267 CLIA NUMBER - LIMA MEMORIAL HEALTH SYSTEM KIDNEY SERVICES

Laboratory Demographics

  • CLIA Code: 36D2063267
  • Facility Name: LIMA MEMORIAL HEALTH SYSTEM KIDNEY SERVICES
  • Facility Address: 1005 BELLEFONTAINE AVE STE 230
    LIMA, OH
    ZIP 45804
  • Facility Phone: 419 998-8255
  • Facility Type: Physician Office
  • Facility Type: Microscopy
  • Lab Director: NASIM MASTOURI
  • NPI Number: 1043761356
  • Taxonomy: 207RC0000X - Internal Medicine

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CLIA Record

Field Name Field Value
CLIA Number 36D2063267
LAB Type Physician Office
Facility Name LIMA MEMORIAL HEALTH SYSTEM KIDNEY SERVICES
Street 1005 BELLEFONTAINE AVE STE 230
City LIMA
State OH
ZIP 45804
Phone 419 998-8255
Certificate Type Certificate for Provider-Performed Microscopy Procedures (PPMP)
Certificate Type Description This certificate is issued to a laboratory in which a physician, midlevel practitioner or dentist performs no tests other than the microscopy procedures. This certificate permits the laboratory to also perform waived tests.
Certificate Effective Date 7/31/2025
Certificate Expiration Date 7/30/2027
Facility Type Physician Office
Lab Director NASIM MASTOURI

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