36D2280502 CLIA NUMBER - MUKUNDA MEDICAL GROUP, LLC

Laboratory Demographics

  • CLIA Code: 36D2280502
  • Facility Name: MUKUNDA MEDICAL GROUP, LLC
  • Facility Address: 6559 WILSON MILLS RD STE 106
    MAYFIELD VILLAGE, OH
    ZIP 44143
  • Facility Phone: 855 449-1540
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: BEEJADI N. MUKUNDA
  • NPI Number: 1043915770
  • Taxonomy: 207R00000X - Internal Medicine

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CLIA Record

Field Name Field Value
CLIA Number 36D2280502
LAB Type Physician Office
Facility Name MUKUNDA MEDICAL GROUP, LLC
Street 6559 WILSON MILLS RD STE 106
City MAYFIELD VILLAGE
State OH
ZIP 44143
Phone 855 449-1540
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/20/2025
Certificate Expiration Date 4/19/2027
Facility Type Physician Office
Lab Director BEEJADI N. MUKUNDA

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