36D0966038 CLIA NUMBER - SOUTHEAST HEALTHCARE

Laboratory Demographics

  • CLIA Code: 36D0966038
  • Facility Name: SOUTHEAST HEALTHCARE
  • Facility Address: 16 W LONG STREET/FIRST FLOOR
    COLUMBUS, OH
    ZIP 43215
  • Facility Phone: 614 225-0980
  • Facility Type: Community Clinic
  • Facility Type: Waiver
  • Lab Director: ABUL HASAN
  • NPI Number: 1497292775
  • Taxonomy: 261QF0400X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 36D0966038
LAB Type Community Clinic
Facility Name SOUTHEAST HEALTHCARE
Street 16 W LONG STREET/FIRST FLOOR
City COLUMBUS
State OH
ZIP 43215
Phone 614 225-0980
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 6/1/2025
Certificate Expiration Date 5/31/2027
Facility Type Community Clinic
Lab Director ABUL HASAN

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