36D2275214 CLIA NUMBER - TOLEDO CLINIC NWO PCCS MAUMEE

Laboratory Demographics

  • CLIA Code: 36D2275214
  • Facility Name: TOLEDO CLINIC NWO PCCS MAUMEE
  • Facility Address: 1661 HOLLAND ROAD SUITE 200
    MAUMEE, OH
    ZIP 43537
  • Facility Phone: 419 843-7800
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: JAMEY RUIZ
  • NPI Number: 1346997293
  • Taxonomy: 2085R0001X - Radiology

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CLIA Record

Field Name Field Value
CLIA Number 36D2275214
LAB Type Physician Office
Facility Name TOLEDO CLINIC NWO PCCS MAUMEE
Street 1661 HOLLAND ROAD SUITE 200
City MAUMEE
State OH
ZIP 43537
Phone 419 843-7800
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 1/18/2025
Certificate Expiration Date 1/17/2027
Facility Type Physician Office
Lab Director JAMEY RUIZ

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