36D2296030 CLIA NUMBER - PROMEDICA PHYSICIANS PEDIATRIC PULMONARY ASSOCIATES

Laboratory Demographics

  • CLIA Code: 36D2296030
  • Facility Name: PROMEDICA PHYSICIANS PEDIATRIC PULMONARY ASSOCIATES
  • Facility Address: 2121 HUGHES DR STE 640
    TOLEDO, OH
    ZIP 43606
  • Facility Phone: 419 291-2207
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: JENNIFER M. RUDDY
  • NPI Number: 1548461288
  • Taxonomy: 2080P0214X - Pediatrics

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CLIA Record

Field Name Field Value
CLIA Number 36D2296030
LAB Type Physician Office
Facility Name PROMEDICA PHYSICIANS PEDIATRIC PULMONARY ASSOCIATES
Street 2121 HUGHES DR STE 640
City TOLEDO
State OH
ZIP 43606
Phone 419 291-2207
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 12/20/2023
Certificate Expiration Date 12/19/2025
Facility Type Physician Office
Lab Director JENNIFER M. RUDDY

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