36D0347821 CLIA NUMBER - MONTGOMERY PEDIATRICS, INC

Laboratory Demographics

  • CLIA Code: 36D0347821
  • Facility Name: MONTGOMERY PEDIATRICS, INC
  • Facility Address: 9157 MONTGOMERY ROAD SUITE 100
    CINCINNATI, OH
    ZIP 45242
  • Facility Phone: 513 984-5552
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: SHARON D'SOUZA
  • NPI Number: 1194917062
  • Taxonomy: 305R00000X - Preferred Provider Organization

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CLIA Record

Field Name Field Value
CLIA Number 36D0347821
LAB Type Physician Office
Facility Name MONTGOMERY PEDIATRICS, INC
Street 9157 MONTGOMERY ROAD SUITE 100
City CINCINNATI
State OH
ZIP 45242
Phone 513 984-5552
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 6/3/2024
Certificate Expiration Date 6/2/2026
Facility Type Physician Office
Lab Director SHARON D'SOUZA

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