36D0685846 CLIA NUMBER - KETTERING HEALTH MEDICAL GROUP OB-GYN

Laboratory Demographics

  • CLIA Code: 36D0685846
  • Facility Name: KETTERING HEALTH MEDICAL GROUP OB-GYN
  • Facility Address: 6438 WILMINGTON PIKE, STE 300
    CENTERVILLE, OH
    ZIP 45459
  • Facility Phone: 937 848-4850
  • Facility Type: Physician Office
  • Facility Type: Microscopy
  • Lab Director: WILLIAM M. MCCULLOUGH JR
  • NPI Number: 1770831729
  • Taxonomy: 207V00000X - Obstetrics & Gynecology

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CLIA Record

Field Name Field Value
CLIA Number 36D0685846
LAB Type Physician Office
Facility Name KETTERING HEALTH MEDICAL GROUP OB-GYN
Street 6438 WILMINGTON PIKE, STE 300
City CENTERVILLE
State OH
ZIP 45459
Phone 937 848-4850
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 WILLIAM M. MCCULLOUGH JR

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