CLIA lab
CLIA 36D2309523: Grand Lake Pediatrics
Wapakoneta, OH. Certificate and address details from the CMS Provider of Services file for clinical laboratories.
CLIA number 36D2309523 belongs to Grand Lake Pediatrics in Wapakoneta, 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, 2024
- 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
- 36D2309523
- Lab name
- Grand Lake Pediatrics
- Address
- 812 Redskin Trail, Suite B1, Wapakoneta, OH 45895
- Phone
- (419) 394-9579
- Fax
- (419) 394-9580
Annual test volume the lab reported
- Waived tests
- 100
Volumes are what the lab reported to CMS on its CMS-116 application, as carried in the file.
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- Lmhs Wapakoneta Medical CenterCertificate of Waiver, Physician office36D0351951
- Mathew M Jose MD IncCertificate for Provider-Performed Microscopy Procedures, Physician office36D0351935
- Mercy Health - Wapakoneta YmcaCertificate of Waiver, Physician office36D2147848
- New Vision Nursing and Home Care LLCCertificate of Waiver, Home health agency36D1071339
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- Victress Health and Wellness, LLCCertificate of Waiver, Other practitioner36D2349570
- Walmart Pharmacy #10-3300Certificate of Waiver, Pharmacy36D2157777
Related
Questions
What is the CLIA number for Grand Lake Pediatrics in Wapakoneta?
36D2309523, per the CMS Provider of Services file posted October 16, 2026.
What CLIA certificate does Grand Lake Pediatrics hold?
A Certificate of Waiver, according to the CMS file.
When does CLIA 36D2309523 expire?
The CMS file lists August 15, 2028 as the certificate expiration date; the certificate took effect August 16, 2026.