36D1009836 CLIA NUMBER - AG CARDIOLOGY

Laboratory Demographics

  • CLIA Code: 36D1009836
  • Facility Name: AG CARDIOLOGY
  • Facility Address: 5062 STATE ROUTE 125
    GEORGETOWN, OH
    ZIP 45121
  • Facility Phone: (937) 378-9090
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: ALI GHASEMZADEH MD
  • NPI Number: 1174700306
  • Taxonomy: 207RC0000X - Internal Medicine

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CLIA Record

Field Name Field Value
CLIA Number 36D1009836
LAB Type Physician Office
Facility Name AG CARDIOLOGY
Street 5062 STATE ROUTE 125
City GEORGETOWN
State OH
ZIP 45121
Phone 9373789090
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 2/26/2025
Certificate Expiration Date 2/25/2027
Facility Type Physician Office
Lab Director ALI GHASEMZADEH MD

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