36D0350387 CLIA NUMBER - NORTHPARKE INTERNAL MEDICINE

Laboratory Demographics

  • CLIA Code: 36D0350387
  • Facility Name: NORTHPARKE INTERNAL MEDICINE
  • Facility Address: 211 NORTHPARKE DRIVE
    SPRINGFIELD, OH
    ZIP 45503
  • Facility Phone: 937 390-1700
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: IMTIAZ S. AHMED
  • NPI Number: 1740206929
  • Taxonomy: 207R00000X - Internal Medicine

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CLIA Record

Field Name Field Value
CLIA Number 36D0350387
LAB Type Physician Office
Facility Name NORTHPARKE INTERNAL MEDICINE
Street 211 NORTHPARKE DRIVE
City SPRINGFIELD
State OH
ZIP 45503
Phone 937 390-1700
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/20/2025
Certificate Expiration Date 9/19/2027
Facility Type Physician Office
Lab Director IMTIAZ S. AHMED

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