CLIA lab
CLIA 36D2117367: Licking Memorial Family Practice
Newark, OH. Certificate and address details from the CMS Provider of Services file for clinical laboratories.
CLIA number 36D2117367 belongs to Licking Memorial Family Practice in Newark, OH.
Certificate of Waiver, effective August 16, 2026, expires August 15, 2028.
Active in the CMS Provider of Services file posted October 16, 2026.
Source: CMS Provider of Services File, Clinical Laboratories (CLIA), as of October 16, 2026. Publisher page
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Certificate
- Certificate type
- Certificate of Waiver
- Certificate effective
- August 16, 2026
- Certificate expiration
- August 15, 2028
- Status in the CMS file
- Active (termination code 00)
- Original participation date
- August 16, 2016
- Facility type
- Physician office
- Ownership (control type)
- Private
- Lab classification
- CLIA laboratory
Source: CMS Provider of Services File, Clinical Laboratories (CLIA), as of October 16, 2026. Publisher page
Lab and contact
- CLIA number
- 36D2117367
- Lab name
- Licking Memorial Family Practice
- Additional name
- West Main
- Address
- 1717 West Main Street, Suite 200, Newark, OH 43055
- Phone
- (220) 564-1706
- Fax
- (220) 564-1707
Annual test volume the lab reported
- Waived tests
- 300
Volumes are what the lab reported to CMS on its CMS-116 application, as carried in the file.
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- Anew Behavioral Health, LLCCertificate of Waiver, Other36D2344321
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- Befford Spine and RehabCertificate of Waiver, Other practitioner36D1060378
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- Biomat Holdings, LLC - GrifolsCertificate of Accreditation, Other36D2285020
- Brightview, LLCCertificate of Waiver, Physician office36D2223904
Related
Questions
What is the CLIA number for Licking Memorial Family Practice in Newark?
36D2117367, per the CMS Provider of Services file posted October 16, 2026.
What CLIA certificate does Licking Memorial Family Practice hold?
A Certificate of Waiver, according to the CMS file.
When does CLIA 36D2117367 expire?
The CMS file lists August 15, 2028 as the certificate expiration date; the certificate took effect August 16, 2026.