36D0349842 CLIA NUMBER - BEAVERTOWN CLINIC INC

Laboratory Demographics

  • CLIA Code: 36D0349842
  • Facility Name: BEAVERTOWN CLINIC INC
  • Facility Address: 3017 WILMINGTON PIKE
    DAYTON, OH
    ZIP 45429
  • Facility Phone: 937 294-2555
  • Facility Type: Physician Office
  • Facility Type: Microscopy
  • Lab Director: KARL G. ROSE
  • NPI Number: 1902803703
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 36D0349842
LAB Type Physician Office
Facility Name BEAVERTOWN CLINIC INC
Street 3017 WILMINGTON PIKE
City DAYTON
State OH
ZIP 45429
Phone 937 294-2555
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 KARL G. ROSE

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