36D2090126 CLIA NUMBER - ANDOVER PRIMARY CARE

Laboratory Demographics

  • CLIA Code: 36D2090126
  • Facility Name: ANDOVER PRIMARY CARE
  • Facility Address: 5594 STATE ROUTE 7
    ANDOVER, OH
    ZIP 44003
  • Facility Phone: 440 293-2444
  • Facility Type: Federally Qualified Health Center
  • Facility Type: Waiver
  • Lab Director: HENRY D. DEBIEC
  • NPI Number: 1821295387
  • Taxonomy: 261QF0400X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 36D2090126
LAB Type Federally Qualified Health Center
Facility Name ANDOVER PRIMARY CARE
Street 5594 STATE ROUTE 7
City ANDOVER
State OH
ZIP 44003
Phone 440 293-2444
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 1/15/2025
Certificate Expiration Date 1/14/2027
Facility Type Federally Qualified Health Center
Lab Director HENRY D. DEBIEC

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