36D1035343 CLIA NUMBER - MCEMO AMBULATORY CARE CLINIC

Laboratory Demographics

  • CLIA Code: 36D1035343
  • Facility Name: MCEMO AMBULATORY CARE CLINIC
  • Facility Address: 5965 E BROAD STREET, STE 200
    COLUMBUS, OH
    ZIP 43213
  • Facility Phone: 614 234-8868
  • Facility Type: Other - ANTICOAGULATION CENTER
  • Facility Type: Waiver
  • Lab Director: RANDAL C. MILES
  • NPI Number: 1669504387
  • Taxonomy: 2083X0100X - Preventive Medicine

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CLIA Record

Field Name Field Value
CLIA Number 36D1035343
LAB Type Other - ANTICOAGULATION CENTER
Facility Name MCEMO AMBULATORY CARE CLINIC
Street 5965 E BROAD STREET, STE 200
City COLUMBUS
State OH
ZIP 43213
Phone 614 234-8868
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 12/30/2024
Certificate Expiration Date 12/29/2026
Facility Type Other - ANTICOAGULATION CENTER
Lab Director RANDAL C. MILES

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