36D1082290 CLIA NUMBER - CINCINNATI HEALTH NETWORK INC

Laboratory Demographics

  • CLIA Code: 36D1082290
  • Facility Name: CINCINNATI HEALTH NETWORK INC
  • Facility Address: MCMICKEN CLINIC AND MOBILE VAN 40 E MCMICKEN AVENUE, 2ND FLOOR
    CINCINNATI, OH
    ZIP 45202
  • Facility Phone: 513 352-6364
  • Facility Type: Federally Qualified Health Center
  • Facility Type: Microscopy
  • Lab Director: ROBERT P. DONOVAN MD
  • NPI Number: 1790867810
  • Taxonomy: 207RC0000X - Internal Medicine

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CLIA Record

Field Name Field Value
CLIA Number 36D1082290
LAB Type Federally Qualified Health Center
Facility Name CINCINNATI HEALTH NETWORK INC
Street MCMICKEN CLINIC AND MOBILE VAN 40 E MCMICKEN AVENUE, 2ND FLOOR
City CINCINNATI
State OH
ZIP 45202
Phone 513 352-6364
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 4/4/2024
Certificate Expiration Date 4/3/2026
Facility Type Federally Qualified Health Center
Lab Director ROBERT P. DONOVAN MD

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