36D2188018 CLIA NUMBER - DEDICATED SENIOR MEDICAL CENTER WEST PARK

Laboratory Demographics

  • CLIA Code: 36D2188018
  • Facility Name: DEDICATED SENIOR MEDICAL CENTER WEST PARK
  • Facility Address: 13719 LORAIN AVE
    CLEVELAND, OH
    ZIP 44111
  • Facility Phone: (305) 842-3910
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: GORDON CHEN
  • NPI Number: 1295368397
  • Taxonomy: 332900000X - Non-Pharmacy Dispensing Site

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CLIA Record

Field Name Field Value
CLIA Number 36D2188018
LAB Type Physician Office
Facility Name DEDICATED SENIOR MEDICAL CENTER WEST PARK
Street 13719 LORAIN AVE
City CLEVELAND
State OH
ZIP 44111
Phone 3058423910
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: 5/18/2026