36D0696846 CLIA NUMBER - BEAVERCREEK FAMILY PHYSICIANS

Laboratory Demographics

  • CLIA Code: 36D0696846
  • Facility Name: BEAVERCREEK FAMILY PHYSICIANS
  • Facility Address: 1244 MEADOWBRIDGE DR STE 100 ATTN OFFICE MANAGER
    BEAVERCREEK, OH
    ZIP 45434
  • Facility Phone: 937 208-7600
  • Facility Type: Physician Office
  • Facility Type: Microscopy
  • Lab Director: RICHARD J. SUROWIEC
  • NPI Number: 1205888963
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 36D0696846
LAB Type Physician Office
Facility Name BEAVERCREEK FAMILY PHYSICIANS
Street 1244 MEADOWBRIDGE DR STE 100 ATTN OFFICE MANAGER
City BEAVERCREEK
State OH
ZIP 45434
Phone 937 208-7600
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 RICHARD J. SUROWIEC

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