36D0349249 CLIA NUMBER - PREMIER HEALTH INTERNAL MEDICINE OF ENGLEWOOD

Laboratory Demographics

  • CLIA Code: 36D0349249
  • Facility Name: PREMIER HEALTH INTERNAL MEDICINE OF ENGLEWOOD
  • Facility Address: 9000 N MAIN STREET SUITE 305
    DAYTON, OH
    ZIP 45415
  • Facility Phone: 937 832-9322
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: ABDUL N. BUTMAN MD
  • NPI Number: 1770623340
  • Taxonomy: 207RC0000X - Internal Medicine

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CLIA Record

Field Name Field Value
CLIA Number 36D0349249
LAB Type Physician Office
Facility Name PREMIER HEALTH INTERNAL MEDICINE OF ENGLEWOOD
Street 9000 N MAIN STREET SUITE 305
City DAYTON
State OH
ZIP 45415
Phone 937 832-9322
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/1/2025
Certificate Expiration Date 3/31/2027
Facility Type Physician Office
Lab Director ABDUL N. BUTMAN MD

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