36D1061327 CLIA NUMBER - SOUTH TOWN FAMILY PRACTICE

Laboratory Demographics

  • CLIA Code: 36D1061327
  • Facility Name: SOUTH TOWN FAMILY PRACTICE
  • Facility Address: 6611 CLYO ROAD SUITE B
    CENTERVILLE, OH
    ZIP 45459
  • Facility Phone: 937 208-7474
  • Facility Type: Physician Office
  • Facility Type: Microscopy
  • Lab Director: JULIA A. BOYD MD
  • NPI Number: 1417032764
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 36D1061327
LAB Type Physician Office
Facility Name SOUTH TOWN FAMILY PRACTICE
Street 6611 CLYO ROAD SUITE B
City CENTERVILLE
State OH
ZIP 45459
Phone 937 208-7474
Certificate Type Certificate for Provider-Performed Microscopy Procedures (PPMP)
Certificate Type Description This certificate is issued to a laboratory in which a physician, midlevel practitioner or dentist performs no tests other than the microscopy procedures. This certificate permits the laboratory to also perform waived tests.
Certificate Effective Date 11/15/2024
Certificate Expiration Date 11/14/2026
Facility Type Physician Office
Lab Director JULIA A. BOYD MD

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