36D0679533 CLIA NUMBER - MADISON PEDIATRICS INC

Laboratory Demographics

  • CLIA Code: 36D0679533
  • Facility Name: MADISON PEDIATRICS INC
  • Facility Address: 55 PARK AVENUE SUITE 210
    LONDON, OH
    ZIP 43140
  • Facility Phone: 740 845-7720
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: GREGG M. ALEXANDER DO
  • NPI Number: 1407998347
  • Taxonomy: 208000000X - Pediatrics

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CLIA Record

Field Name Field Value
CLIA Number 36D0679533
LAB Type Physician Office
Facility Name MADISON PEDIATRICS INC
Street 55 PARK AVENUE SUITE 210
City LONDON
State OH
ZIP 43140
Phone 740 845-7720
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/1/2024
Certificate Expiration Date 8/31/2026
Facility Type Physician Office
Lab Director GREGG M. ALEXANDER DO

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