36D2297419 CLIA NUMBER - LAKEVIEW WELLNESS

Laboratory Demographics

  • CLIA Code: 36D2297419
  • Facility Name: LAKEVIEW WELLNESS
  • Facility Address: 619 FULTON ST, SUITE 200
    PORT CLINTON, OH
    ZIP 43452
  • Facility Phone: 419 732-2614
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: SHOSHANA EISENSTEIN
  • NPI Number: 1144099524
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 36D2297419
LAB Type Physician Office
Facility Name LAKEVIEW WELLNESS
Street 619 FULTON ST, SUITE 200
City PORT CLINTON
State OH
ZIP 43452
Phone 419 732-2614
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 1/16/2024
Certificate Expiration Date 1/15/2026
Facility Type Physician Office
Lab Director SHOSHANA EISENSTEIN

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