36D2175408 CLIA NUMBER - PROMEDICA PHYSICIANS WOOD COUNTY SCHOOL CONSORTIUM

Laboratory Demographics

  • CLIA Code: 36D2175408
  • Facility Name: PROMEDICA PHYSICIANS WOOD COUNTY SCHOOL CONSORTIUM
  • Facility Address: 1180 N MAIN STREET, SUITE 5
    BOWLING GREEN, OH
    ZIP 43402
  • Facility Phone: 419 315-1225
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: ALYSE M. SNIDER
  • NPI Number: 1568001352
  • Taxonomy: 261Q00000X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 36D2175408
LAB Type Physician Office
Facility Name PROMEDICA PHYSICIANS WOOD COUNTY SCHOOL CONSORTIUM
Street 1180 N MAIN STREET, SUITE 5
City BOWLING GREEN
State OH
ZIP 43402
Phone 419 315-1225
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 11/20/2023
Certificate Expiration Date 11/19/2025
Facility Type Physician Office
Lab Director ALYSE M. SNIDER

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