36D0712182 CLIA NUMBER - INTERNAL MEDICINE CARE INC

Laboratory Demographics

  • CLIA Code: 36D0712182
  • Facility Name: INTERNAL MEDICINE CARE INC
  • Facility Address: 2633 COMMONS BLVD, SUITE 120
    BEAVERCREEK, OH
    ZIP 45431
  • Facility Phone: 937 429-0607
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: INGRID BROWN
  • NPI Number: 1962582908
  • Taxonomy: 207R00000X - Internal Medicine

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CLIA Record

Field Name Field Value
CLIA Number 36D0712182
LAB Type Physician Office
Facility Name INTERNAL MEDICINE CARE INC
Street 2633 COMMONS BLVD, SUITE 120
City BEAVERCREEK
State OH
ZIP 45431
Phone 937 429-0607
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 INGRID BROWN

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