36D2192740 CLIA NUMBER - AZIMUTH MEDICAL, LLC

Laboratory Demographics

  • CLIA Code: 36D2192740
  • Facility Name: AZIMUTH MEDICAL, LLC
  • Facility Address: 1701 MENTOR AVE SUITE 10
    PAINESVILLE, OH
    ZIP 44077
  • Facility Phone: 440 898-0058
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: RICHARD S. KRUPKIN
  • NPI Number: 1699362863
  • Taxonomy: 261QH0100X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 36D2192740
LAB Type Physician Office
Facility Name AZIMUTH MEDICAL, LLC
Street 1701 MENTOR AVE SUITE 10
City PAINESVILLE
State OH
ZIP 44077
Phone 440 898-0058
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/14/2024
Certificate Expiration Date 9/13/2026
Facility Type Physician Office
Lab Director RICHARD S. KRUPKIN

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