36D2228127 CLIA NUMBER - NORTHERN OHIO MEDICAL SPECIALISTS, LLC

Laboratory Demographics

  • CLIA Code: 36D2228127
  • Facility Name: NORTHERN OHIO MEDICAL SPECIALISTS, LLC
  • Facility Address: 282 BENEDICT AVE, SUITE D, MEDICAL PARK 2 SUITE D, MEDICAL PARK 2
    NORWALK, OH
    ZIP 44857
  • Facility Phone: 419 625-2841
  • Facility Type: Physician Office
  • Facility Type: Microscopy
  • Lab Director: DR. MONA NATAPRAWIRA
  • NPI Number: 1396484903
  • Taxonomy: 332B00000X - Durable Medical Equipment & Medical Supplies

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CLIA Record

Field Name Field Value
CLIA Number 36D2228127
LAB Type Physician Office
Facility Name NORTHERN OHIO MEDICAL SPECIALISTS, LLC
Street 282 BENEDICT AVE, SUITE D, MEDICAL PARK 2 SUITE D, MEDICAL PARK 2
City NORWALK
State OH
ZIP 44857
Phone 419 625-2841
Certificate Type Certificate for Provider-Performed Microscopy Procedures (PPMP)
Certificate Type Description This certificate is issued to a laboratory in which a physician, midlevel practitioner or dentist performs no tests other than the microscopy procedures. This certificate permits the laboratory to also perform waived tests.
Certificate Effective Date 6/22/2025
Certificate Expiration Date 6/21/2027
Facility Type Physician Office
Lab Director DR. MONA NATAPRAWIRA

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