36D2264906 CLIA NUMBER - ID CONSULTANTS, INC

Laboratory Demographics

  • CLIA Code: 36D2264906
  • Facility Name: ID CONSULTANTS, INC
  • Facility Address: 3401 ENTERPRISE PKWY, SUITE 110
    BEACHWOOD, OH
    ZIP 44122
  • Facility Phone: 216 360-0456
  • Facility Type: Other - INFUSION CENTER
  • Facility Type: Waiver
  • Lab Director: LEEANN PURTTHIPATKOOL
  • NPI Number: 1255913117
  • Taxonomy: 207RI0200X - Internal Medicine

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CLIA Record

Field Name Field Value
CLIA Number 36D2264906
LAB Type Other - INFUSION CENTER
Facility Name ID CONSULTANTS, INC
Street 3401 ENTERPRISE PKWY, SUITE 110
City BEACHWOOD
State OH
ZIP 44122
Phone 216 360-0456
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 7/20/2024
Certificate Expiration Date 7/19/2026
Facility Type Other - INFUSION CENTER
Lab Director LEEANN PURTTHIPATKOOL

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This page was last updated on: 3/20/2025