36D0906522 CLIA NUMBER - CENTRAL OHIO PRIMARY CARE PHY INC

Laboratory Demographics

  • CLIA Code: 36D0906522
  • Facility Name: CENTRAL OHIO PRIMARY CARE PHY INC
  • Facility Address: 5070 BRADENTON AVENUE
    DUBLIN, OH
    ZIP 43017
  • Facility Phone: 614 764-1777
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: KRISTOPHER HANSON
  • NPI Number: 1861773830
  • Taxonomy: 335E00000X - Prosthetic/Orthotic Supplier

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CLIA Record

Field Name Field Value
CLIA Number 36D0906522
LAB Type Physician Office
Facility Name CENTRAL OHIO PRIMARY CARE PHY INC
Street 5070 BRADENTON AVENUE
City DUBLIN
State OH
ZIP 43017
Phone 614 764-1777
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/2/2025
Certificate Expiration Date 10/1/2027
Facility Type Physician Office
Lab Director KRISTOPHER HANSON

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