36D1062943 CLIA NUMBER - CHALLA AJIT MD LLC

Laboratory Demographics

  • CLIA Code: 36D1062943
  • Facility Name: CHALLA AJIT MD LLC
  • Facility Address: 2355 DERR ROAD
    SPRINGFIELD, OH
    ZIP 45503
  • Facility Phone: 937 568-7070
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: CHALLA AJIT MD
  • NPI Number: 1598778805
  • Taxonomy: 207RG0100X - Internal Medicine

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CLIA Record

Field Name Field Value
CLIA Number 36D1062943
LAB Type Physician Office
Facility Name CHALLA AJIT MD LLC
Street 2355 DERR ROAD
City SPRINGFIELD
State OH
ZIP 45503
Phone 937 568-7070
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 1/2/2025
Certificate Expiration Date 1/1/2027
Facility Type Physician Office
Lab Director CHALLA AJIT MD

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