36D2180412 CLIA NUMBER - PERRYSBURG CENTER FOR PAIN MANAGEMENT

Laboratory Demographics

  • CLIA Code: 36D2180412
  • Facility Name: PERRYSBURG CENTER FOR PAIN MANAGEMENT
  • Facility Address: 1090 W SOUTH BOUNDARY
    PERRYSBURG, OH
    ZIP 43551
  • Facility Phone: 419 843-1370
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: MICHAEL MAYMIND
  • NPI Number: 1073054219
  • Taxonomy: 1041C0700X - Social Worker

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CLIA Record

Field Name Field Value
CLIA Number 36D2180412
LAB Type Physician Office
Facility Name PERRYSBURG CENTER FOR PAIN MANAGEMENT
Street 1090 W SOUTH BOUNDARY
City PERRYSBURG
State OH
ZIP 43551
Phone 419 843-1370
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/13/2024
Certificate Expiration Date 3/12/2026
Facility Type Physician Office
Lab Director MICHAEL MAYMIND

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