36D1011394 CLIA NUMBER - TAJ MEDICAL INC

Laboratory Demographics

  • CLIA Code: 36D1011394
  • Facility Name: TAJ MEDICAL INC
  • Facility Address: 1174 EAST HOME ROAD SUITE N
    SPRINGFIELD, OH
    ZIP 45503
  • Facility Phone: 937 398-0354
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: ASHFAQ T. AHMED
  • NPI Number: 1811914765
  • Taxonomy: 207RC0000X - Internal Medicine

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CLIA Record

Field Name Field Value
CLIA Number 36D1011394
LAB Type Physician Office
Facility Name TAJ MEDICAL INC
Street 1174 EAST HOME ROAD SUITE N
City SPRINGFIELD
State OH
ZIP 45503
Phone 937 398-0354
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/9/2025
Certificate Expiration Date 4/8/2027
Facility Type Physician Office
Lab Director ASHFAQ T. AHMED

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