36D0872306 CLIA NUMBER - DAYTON - SOUTH

Laboratory Demographics

  • CLIA Code: 36D0872306
  • Facility Name: DAYTON - SOUTH
  • Facility Address: 1435 CINCINNATI STREET, SUITE 100
    DAYTON, OH
    ZIP 45408
  • Facility Phone: (937) 449-0800
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: DAVID WALL
  • NPI Number: 1215704622
  • Taxonomy: 310400000X - Assisted Living Facility

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CLIA Record

Field Name Field Value
CLIA Number 36D0872306
LAB Type Physician Office
Facility Name DAYTON - SOUTH
Street 1435 CINCINNATI STREET, SUITE 100
City DAYTON
State OH
ZIP 45408
Phone 9374490800
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 6/11/2025
Certificate Expiration Date 6/10/2027
Facility Type Physician Office
Lab Director DAVID WALL

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This page was last updated on: 5/18/2026