36D0348686 CLIA NUMBER - UPPER VALLEY FAMILY MEDICINE

Laboratory Demographics

  • CLIA Code: 36D0348686
  • Facility Name: UPPER VALLEY FAMILY MEDICINE
  • Facility Address: 998 S DORSET RD STE 301
    TROY, OH
    ZIP 45373
  • Facility Phone: 937 339-9865
  • Facility Type: Physician Office
  • Facility Type: Microscopy
  • Lab Director: IRINA A. GENDLER
  • NPI Number: 1053549261
  • Taxonomy: 207RN0300X - Internal Medicine

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CLIA Record

Field Name Field Value
CLIA Number 36D0348686
LAB Type Physician Office
Facility Name UPPER VALLEY FAMILY MEDICINE
Street 998 S DORSET RD STE 301
City TROY
State OH
ZIP 45373
Phone 937 339-9865
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 9/1/2024
Certificate Expiration Date 8/31/2026
Facility Type Physician Office
Lab Director IRINA A. GENDLER

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