36D1069328 CLIA NUMBER - PHYSICIAN ASSOCIATES OF NORTHERN CINCINNATI LLC

Laboratory Demographics

CLIA Number: 36D1069328

Facility Name: PHYSICIAN ASSOCIATES OF NORTHERN CINCINNATI LLC

Facility Address:
3801 HAUCK ROAD SUITE A
CINCINNATI, OH
ZIP 45241
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Facility Phone Number: 513 671-1702

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1144533407

Taxonomy: 207Q00000X - Family Medicine
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.

CLIA Record

Field Name	Field Value
CLIA Number	36D1069328
LAB Type	Physician Office
Facility Name	PHYSICIAN ASSOCIATES OF NORTHERN CINCINNATI LLC
Street	3801 HAUCK ROAD SUITE A
City	CINCINNATI
State	OH
ZIP	45241
Phone	513 671-1702
CertificateType	4
CertificateEffectiveDate	6/1/2023
CertificateExpirationDate	5/31/2025
FacilityType	Waiver

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This page was last updated on: 4/23/2024