36D2271806 CLIA NUMBER - CLARK FAMILY PRACTICE LLC

Laboratory Demographics

  • CLIA Code: 36D2271806
  • Facility Name: CLARK FAMILY PRACTICE LLC
  • Facility Address: 293 MAIN ST
    BYESVILLE, OH
    ZIP 43723
  • Facility Phone: 740 680-1227
  • Facility Type: Practitioner Other
  • Facility Type: Waiver
  • Lab Director: ELISHA A. CLARK
  • NPI Number: 1528799186
  • Taxonomy: 363L00000X - Nurse Practitioner

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CLIA Record

Field Name Field Value
CLIA Number 36D2271806
LAB Type Practitioner Other
Facility Name CLARK FAMILY PRACTICE LLC
Street 293 MAIN ST
City BYESVILLE
State OH
ZIP 43723
Phone 740 680-1227
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 11/8/2024
Certificate Expiration Date 11/7/2026
Facility Type Practitioner Other
Lab Director ELISHA A. CLARK

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