36D2303956 CLIA NUMBER - INDEPENDENCE HEALTH EMPLOYER SERVICES, LLC MAUMEE

Laboratory Demographics

  • CLIA Code: 36D2303956
  • Facility Name: INDEPENDENCE HEALTH EMPLOYER SERVICES, LLC MAUMEE
  • Facility Address: 5757 MONCLOVA ROAD, STE 17
    MAUMEE, OH
    ZIP 43537
  • Facility Phone: 419 891-8003
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: ANDREW R. NOWAKOWSKI
  • NPI Number: 1477208643
  • Taxonomy: 2083X0100X - Preventive Medicine

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CLIA Record

Field Name Field Value
CLIA Number 36D2303956
LAB Type Physician Office
Facility Name INDEPENDENCE HEALTH EMPLOYER SERVICES, LLC MAUMEE
Street 5757 MONCLOVA ROAD, STE 17
City MAUMEE
State OH
ZIP 43537
Phone 419 891-8003
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 5/3/2024
Certificate Expiration Date 5/2/2026
Facility Type Physician Office
Lab Director ANDREW R. NOWAKOWSKI

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