36D0349940 CLIA NUMBER - BEAVERCREEK FAMILY MEDICINE AND OBSTETRICS

Laboratory Demographics

  • CLIA Code: 36D0349940
  • Facility Name: BEAVERCREEK FAMILY MEDICINE AND OBSTETRICS
  • Facility Address: 111 HARBERT DRIVE RIPPLE GLEN PKWY
    BEAVERCREEK, OH
    ZIP 45440
  • Facility Phone: (937) 208-7575
  • Facility Type: Physician Office
  • Facility Type: Microscopy
  • Lab Director: WARREN R. LJUNGREN
  • NPI Number: 1558313460
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 36D0349940
LAB Type Physician Office
Facility Name BEAVERCREEK FAMILY MEDICINE AND OBSTETRICS
Street 111 HARBERT DRIVE RIPPLE GLEN PKWY
City BEAVERCREEK
State OH
ZIP 45440
Phone 9372087575
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 7/28/2024
Certificate Expiration Date 7/27/2026
Facility Type Physician Office
Lab Director WARREN R. LJUNGREN

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This page was last updated on: 5/18/2026