36D0349614 CLIA NUMBER - MIDDLETOWN MEDICAL GROUP INC

Laboratory Demographics

  • CLIA Code: 36D0349614
  • Facility Name: MIDDLETOWN MEDICAL GROUP INC
  • Facility Address: 200 N BREIEL BLVD
    MIDDLETOWN, OH
    ZIP 45042
  • Facility Phone: 513 424-2535
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: MARVIN L. RAY
  • NPI Number: 1477533446
  • Taxonomy: 207R00000X - Internal Medicine

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 36D0349614
LAB Type Physician Office
Facility Name MIDDLETOWN MEDICAL GROUP INC
Street 200 N BREIEL BLVD
City MIDDLETOWN
State OH
ZIP 45042
Phone 513 424-2535
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/27/2024
Certificate Expiration Date 10/26/2026
Facility Type Physician Office
Lab Director MARVIN L. RAY

Download Record

Download this CLIA record record in Text format: Export

Download this CLIA record record in Excel (CSV) format: Export

Download this CLIA record record in XML format: Export

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