36D1098253 CLIA NUMBER - MAGNOLIA WOMEN'S HEALTH

Laboratory Demographics

CLIA Number: 36D1098253

Facility Name: MAGNOLIA WOMEN'S HEALTH

Facility Address:
2350 MIAMI VALLEY DRIVE SUITE 420 MIAMI VALLEY CENTER SOUTH
CENTERVILLE, OH
ZIP 45459
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Facility Phone Number: 937 208-4110

Facility Type: Physician Office

Certificate Type: Microscopy

NPI Number: 1891308011

Taxonomy: 261QD0000X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	36D1098253
LAB Type	Physician Office
Facility Name	MAGNOLIA WOMEN'S HEALTH
Street	2350 MIAMI VALLEY DRIVE SUITE 420 MIAMI VALLEY CENTER SOUTH
City	CENTERVILLE
State	OH
ZIP	45459
Phone	937 208-4110
CertificateType	3
CertificateEffectiveDate	11/14/2023
CertificateExpirationDate	11/13/2025
FacilityType	PPMP

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