36D1065587 CLIA NUMBER - WRIGHT STATE UNIVERSITY MT OLIVE

Laboratory Demographics

  • CLIA Code: 36D1065587
  • Facility Name: WRIGHT STATE UNIVERSITY MT OLIVE
  • Facility Address: 502 PONTIAC STREET
    DAYTON, OH
    ZIP 45417
  • Facility Phone: 937 775-1484
  • Facility Type: Other - BEH HEALTH PROGRAM SITES
  • Facility Type: Waiver
  • Lab Director: JOSEPHINE WILSON
  • NPI Number: 1821435595
  • Taxonomy: 282N00000X - General Acute Care Hospital

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CLIA Record

Field Name Field Value
CLIA Number 36D1065587
LAB Type Other - BEH HEALTH PROGRAM SITES
Facility Name WRIGHT STATE UNIVERSITY MT OLIVE
Street 502 PONTIAC STREET
City DAYTON
State OH
ZIP 45417
Phone 937 775-1484
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/6/2025
Certificate Expiration Date 3/5/2027
Facility Type Other - BEH HEALTH PROGRAM SITES
Lab Director JOSEPHINE WILSON

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