36D0701058 CLIA NUMBER - TROTWOOD PHYSICIAN CENTER

Laboratory Demographics

  • CLIA Code: 36D0701058
  • Facility Name: TROTWOOD PHYSICIAN CENTER
  • Facility Address: 3038 OLIVE ROAD
    TROTWOOD, OH
    ZIP 45426
  • Facility Phone: 937 208-7050
  • Facility Type: Physician Office
  • Facility Type: Microscopy
  • Lab Director: KIMBERLY F. BETHEL
  • NPI Number: 1841243862
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 36D0701058
LAB Type Physician Office
Facility Name TROTWOOD PHYSICIAN CENTER
Street 3038 OLIVE ROAD
City TROTWOOD
State OH
ZIP 45426
Phone 937 208-7050
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 KIMBERLY F. BETHEL

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