36D2287779 CLIA NUMBER - PROMEDICA PHYSICIANS PELVIC HEALTH

Laboratory Demographics

  • CLIA Code: 36D2287779
  • Facility Name: PROMEDICA PHYSICIANS PELVIC HEALTH
  • Facility Address: 1620 BRIGHAM DR SUITE 230
    PERRYSBURG, OH
    ZIP 43551
  • Facility Phone: (567) 585-2030
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: NADINE C. KASSIS

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CLIA Record

Field Name Field Value
CLIA Number 36D2287779
LAB Type Physician Office
Facility Name PROMEDICA PHYSICIANS PELVIC HEALTH
Street 1620 BRIGHAM DR SUITE 230
City PERRYSBURG
State OH
ZIP 43551
Phone 5675852030
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/17/2025
Certificate Expiration Date 8/16/2027
Facility Type Physician Office
Lab Director NADINE C. KASSIS

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This page was last updated on: 5/18/2026