36D0330844 CLIA NUMBER - MICHAEL R GLEASON DO LTD

Laboratory Demographics

  • CLIA Code: 36D0330844
  • Facility Name: MICHAEL R GLEASON DO LTD
  • Facility Address: 212 E COLUMBUS AVE STE 3
    BELLEFONTAINE, OH
    ZIP 43311
  • Facility Phone: 937 592-8025
  • Facility Type: Physician Office
  • Facility Type: Microscopy
  • Lab Director: MICHAEL R. GLEASON
  • NPI Number: 1104902824
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 36D0330844
LAB Type Physician Office
Facility Name MICHAEL R GLEASON DO LTD
Street 212 E COLUMBUS AVE STE 3
City BELLEFONTAINE
State OH
ZIP 43311
Phone 937 592-8025
Certificate Type Certificate for Provider-Performed Microscopy Procedures (PPMP)
Certificate Type Description This certificate is issued to a laboratory in which a physician, midlevel practitioner or dentist performs no tests other than the microscopy procedures. This certificate permits the laboratory to also perform waived tests.
Certificate Effective Date 12/18/2023
Certificate Expiration Date 12/17/2025
Facility Type Physician Office
Lab Director MICHAEL R. GLEASON

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