36D2122736 CLIA NUMBER - UHMP GEAUGA FAMILY MEDICINE

Laboratory Demographics

  • CLIA Code: 36D2122736
  • Facility Name: UHMP GEAUGA FAMILY MEDICINE
  • Facility Address: 13221 RAVENNA ROAD SUITE 8A
    CHARDON, OH
    ZIP 44024
  • Facility Phone: 216 337-3822
  • Facility Type: Physician Office
  • Facility Type: Microscopy
  • Lab Director: JOHN M. URBANCIC
  • NPI Number: 1114056124
  • Taxonomy: 207R00000X - Internal Medicine

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CLIA Record

Field Name Field Value
CLIA Number 36D2122736
LAB Type Physician Office
Facility Name UHMP GEAUGA FAMILY MEDICINE
Street 13221 RAVENNA ROAD SUITE 8A
City CHARDON
State OH
ZIP 44024
Phone 216 337-3822
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 12/6/2024
Certificate Expiration Date 12/5/2026
Facility Type Physician Office
Lab Director JOHN M. URBANCIC

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