36D0344950 CLIA NUMBER - INTERNIST OF FAIRFIELD - MMA

Laboratory Demographics

  • CLIA Code: 36D0344950
  • Facility Name: INTERNIST OF FAIRFIELD - MMA
  • Facility Address: 544 PATTERSON BLVD
    FAIRFIELD, OH
    ZIP 45014
  • Facility Phone: 513 896-9595
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: KEVIN P. HARTMAN
  • NPI Number: 1285693010
  • Taxonomy: 207RR0500X - Internal Medicine

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CLIA Record

Field Name Field Value
CLIA Number 36D0344950
LAB Type Physician Office
Facility Name INTERNIST OF FAIRFIELD - MMA
Street 544 PATTERSON BLVD
City FAIRFIELD
State OH
ZIP 45014
Phone 513 896-9595
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 12/23/2023
Certificate Expiration Date 12/22/2025
Facility Type Physician Office
Lab Director KEVIN P. HARTMAN

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