36D0701528 CLIA NUMBER - CHETNA MITAL MD LLC

Laboratory Demographics

  • CLIA Code: 36D0701528
  • Facility Name: CHETNA MITAL MD LLC
  • Facility Address: 1010 CEREAL AVENUE SUITE 103
    HAMILTON, OH
    ZIP 45013
  • Facility Phone: 513 867-2622
  • Facility Type: Practitioner Other
  • Facility Type: Waiver
  • Lab Director: CHETNA MITAL
  • NPI Number: 1285637694
  • Taxonomy: 207R00000X - Internal Medicine

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CLIA Record

Field Name Field Value
CLIA Number 36D0701528
LAB Type Practitioner Other
Facility Name CHETNA MITAL MD LLC
Street 1010 CEREAL AVENUE SUITE 103
City HAMILTON
State OH
ZIP 45013
Phone 513 867-2622
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 11/1/2024
Certificate Expiration Date 10/31/2026
Facility Type Practitioner Other
Lab Director CHETNA MITAL

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