36D2266411 CLIA NUMBER - MEDINA PRIMARY CARE

Laboratory Demographics

  • CLIA Code: 36D2266411
  • Facility Name: MEDINA PRIMARY CARE
  • Facility Address: 279 E REAGAN PARKWAY
    MEDINA, OH
    ZIP 44256
  • Facility Phone: 234 360-0781
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: LISA M. ESTERLE
  • NPI Number: 1427029248
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 36D2266411
LAB Type Physician Office
Facility Name MEDINA PRIMARY CARE
Street 279 E REAGAN PARKWAY
City MEDINA
State OH
ZIP 44256
Phone 234 360-0781
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/10/2024
Certificate Expiration Date 8/9/2026
Facility Type Physician Office
Lab Director LISA M. ESTERLE

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