36D2117710 CLIA NUMBER - THOMAS M KELLY OD INC

Laboratory Demographics

  • CLIA Code: 36D2117710
  • Facility Name: THOMAS M KELLY OD INC
  • Facility Address: 570 DOVER CENTER ROAD
    BAY VILLAGE, OH
    ZIP 44140
  • Facility Phone: 440 871-1139
  • Facility Type: Practitioner Other
  • Facility Type: Waiver
  • Lab Director: THOMAS M. KELLY
  • NPI Number: 1285730986
  • Taxonomy: 152W00000X - Optometrist

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CLIA Record

Field Name Field Value
CLIA Number 36D2117710
LAB Type Practitioner Other
Facility Name THOMAS M KELLY OD INC
Street 570 DOVER CENTER ROAD
City BAY VILLAGE
State OH
ZIP 44140
Phone 440 871-1139
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/23/2024
Certificate Expiration Date 8/22/2026
Facility Type Practitioner Other
Lab Director THOMAS M. KELLY

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