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36D0969890 CLIA NUMBER - CENTRAL OHIO PEDIATRICS ENDOCRINOLOGY AND DIABETES SERVICES

Laboratory Demographics

CLIA Number: 36D0969890

Facility Name: CENTRAL OHIO PEDIATRICS ENDOCRINOLOGY AND DIABETES SERVICES

Facility Address:
55 DILLMONT DR STE 100
COLUMBUS, OH
ZIP 43235
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Facility Phone Number: 614 839-3040

Facility Type: Physician Office

Certificate Type: Waiver
NPI Number: 1467781831

Taxonomy: 3336C0004X - Pharmacy
A pharmacy that specializes in the preparation of components into a drug preparation as the result of a Practitioner's Prescription Drug Order or initiative based on the Practitioner/Patient/Pharmacist relationship in the course of professional practice. A compounding pharmacy utilizes specialized equipment and specially designed facilities necessary to meet the legal and quality requirements of its scope of compounding practice.

CLIA Record

Field Name Field Value
CLIA Number 36D0969890
LAB Type Physician Office
Facility Name CENTRAL OHIO PEDIATRICS ENDOCRINOLOGY AND DIABETES SERVICES
Street 55 DILLMONT DR STE 100
City COLUMBUS
State OH
ZIP 43235
Phone 614 839-3040
CertificateType 4
CertificateEffectiveDate 1/31/2024
CertificateExpirationDate 1/30/2026
FacilityType Waiver

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This page was last updated on: 4/23/2024