36D2128287 CLIA NUMBER - PEDS ON WHEELS

Laboratory Demographics

  • CLIA Code: 36D2128287
  • Facility Name: PEDS ON WHEELS
  • Facility Address: 517 48TH STREET
    SANDUSKY, OH
    ZIP 44870
  • Facility Phone: 419 217-1177
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: ROBERT A. JOHNSON
  • NPI Number: 1225561467
  • Taxonomy: 208000000X - Pediatrics

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CLIA Record

Field Name Field Value
CLIA Number 36D2128287
LAB Type Physician Office
Facility Name PEDS ON WHEELS
Street 517 48TH STREET
City SANDUSKY
State OH
ZIP 44870
Phone 419 217-1177
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/28/2025
Certificate Expiration Date 3/27/2027
Facility Type Physician Office
Lab Director ROBERT A. JOHNSON

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