36D0862153 CLIA NUMBER - TRI STATE UROLOGY DBA THE UROLOGY GROUP

Laboratory Demographics

  • CLIA Code: 36D0862153
  • Facility Name: TRI STATE UROLOGY DBA THE UROLOGY GROUP
  • Facility Address: 200 MEDICAL CENTER DRIVE SUITE 500
    MIDDLETOWN, OH
    ZIP 45005
  • Facility Phone: 513 841-7780
  • Facility Type: Physician Office
  • Facility Type: Microscopy
  • Lab Director: DAVID C. MILLER
  • NPI Number: 1033302054
  • Taxonomy: 208800000X - Urology

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CLIA Record

Field Name Field Value
CLIA Number 36D0862153
LAB Type Physician Office
Facility Name TRI STATE UROLOGY DBA THE UROLOGY GROUP
Street 200 MEDICAL CENTER DRIVE SUITE 500
City MIDDLETOWN
State OH
ZIP 45005
Phone 513 841-7780
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 DAVID C. MILLER

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