36D1027640 CLIA NUMBER - KETTERING HEALTH MEDICAL GROUP CARDIOVASCULAR

Laboratory Demographics

  • CLIA Code: 36D1027640
  • Facility Name: KETTERING HEALTH MEDICAL GROUP CARDIOVASCULAR
  • Facility Address: 1380 E STROOP RD BLDG 2
    KETTERING, OH
    ZIP 45429
  • Facility Phone: 866 224-9472
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: FRANK J. WENZKE
  • NPI Number: 1881684959
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 36D1027640
LAB Type Physician Office
Facility Name KETTERING HEALTH MEDICAL GROUP CARDIOVASCULAR
Street 1380 E STROOP RD BLDG 2
City KETTERING
State OH
ZIP 45429
Phone 866 224-9472
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 7/6/2024
Certificate Expiration Date 7/5/2026
Facility Type Physician Office
Lab Director FRANK J. WENZKE

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