36D0350242 CLIA NUMBER - MAGNOLIA WOMEN'S HEALTH

Laboratory Demographics

  • CLIA Code: 36D0350242
  • Facility Name: MAGNOLIA WOMEN'S HEALTH
  • Facility Address: 7707 PARAGON RD, SUITE 106
    CENTERVILLE, OH
    ZIP 45459
  • Facility Phone: 937 435-1445
  • Facility Type: Physician Office
  • Facility Type: Microscopy
  • Lab Director: BRENT IMBODY
  • NPI Number: 1891308011
  • Taxonomy: 261QD0000X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 36D0350242
LAB Type Physician Office
Facility Name MAGNOLIA WOMEN'S HEALTH
Street 7707 PARAGON RD, SUITE 106
City CENTERVILLE
State OH
ZIP 45459
Phone 937 435-1445
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 5/13/2025
Certificate Expiration Date 5/12/2027
Facility Type Physician Office
Lab Director BRENT IMBODY

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