36D2188015 CLIA NUMBER - DEDICATED SENIOR MEDICAL CENTER COLINWOOD

Laboratory Demographics

  • CLIA Code: 36D2188015
  • Facility Name: DEDICATED SENIOR MEDICAL CENTER COLINWOOD
  • Facility Address: 15105 ST CLAIR AVE
    CLEVELAND, OH
    ZIP 44110
  • Facility Phone: 305 842-3910
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: GORDON CHEN
  • NPI Number: 1023641867
  • Taxonomy: 332900000X - Non-Pharmacy Dispensing Site

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CLIA Record

Field Name Field Value
CLIA Number 36D2188015
LAB Type Physician Office
Facility Name DEDICATED SENIOR MEDICAL CENTER COLINWOOD
Street 15105 ST CLAIR AVE
City CLEVELAND
State OH
ZIP 44110
Phone 305 842-3910
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 7/10/2024
Certificate Expiration Date 7/9/2026
Facility Type Physician Office
Lab Director GORDON CHEN

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