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36D2156433 CLIA NUMBER - ELITE MEDICAL PRACTICE, LLC

Laboratory Demographics

CLIA Number: 36D2156433

Facility Name: ELITE MEDICAL PRACTICE, LLC

Facility Address:
21851 CENTER RIDGE RD #109
ROCKY RIVER, OH
ZIP 44116
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Facility Phone Number: 440 331-5488

Facility Type: Physician Office

Certificate Type: Waiver
NPI Number: 1730674037

Taxonomy: 207R00000X - Internal Medicine
A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.

CLIA Record

Field Name Field Value
CLIA Number 36D2156433
LAB Type Physician Office
Facility Name ELITE MEDICAL PRACTICE, LLC
Street 21851 CENTER RIDGE RD #109
City ROCKY RIVER
State OH
ZIP 44116
Phone 440 331-5488
CertificateType 4
CertificateEffectiveDate 10/18/2022
CertificateExpirationDate 10/17/2024
FacilityType Waiver

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This page was last updated on: 4/23/2024