36D2097049 CLIA NUMBER - WHEATLAND DERMATOLOGY

Laboratory Demographics

  • CLIA Code: 36D2097049
  • Facility Name: WHEATLAND DERMATOLOGY
  • Facility Address: 1050 E GRANVILLE RD
    SAINT MARYS, OH
    ZIP 45885
  • Facility Phone: 419 394-3331
  • Facility Type: Physician Office
  • Facility Type: Microscopy
  • Lab Director: SUZANNE D. QUINTER
  • NPI Number: 1477931608
  • Taxonomy: 207N00000X - Dermatology

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CLIA Record

Field Name Field Value
CLIA Number 36D2097049
LAB Type Physician Office
Facility Name WHEATLAND DERMATOLOGY
Street 1050 E GRANVILLE RD
City SAINT MARYS
State OH
ZIP 45885
Phone 419 394-3331
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 6/8/2025
Certificate Expiration Date 6/7/2027
Facility Type Physician Office
Lab Director SUZANNE D. QUINTER

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