36D1012692 CLIA NUMBER - MADISON HEALTH PRIMARY CARE

Laboratory Demographics

  • CLIA Code: 36D1012692
  • Facility Name: MADISON HEALTH PRIMARY CARE
  • Facility Address: 55 PARK AVE STE 275
    LONDON, OH
    ZIP 43140
  • Facility Phone: 740 845-7500
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: JAMES W. KAEHR
  • NPI Number: 1013362623
  • Taxonomy: 291U00000X - Clinical Medical Laboratory

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CLIA Record

Field Name Field Value
CLIA Number 36D1012692
LAB Type Physician Office
Facility Name MADISON HEALTH PRIMARY CARE
Street 55 PARK AVE STE 275
City LONDON
State OH
ZIP 43140
Phone 740 845-7500
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 5/19/2025
Certificate Expiration Date 5/18/2027
Facility Type Physician Office
Lab Director JAMES W. KAEHR

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