36D1106896 CLIA NUMBER - KETTERING HEALTH MATERNAL FETAL MEDICINE

Laboratory Demographics

  • CLIA Code: 36D1106896
  • Facility Name: KETTERING HEALTH MATERNAL FETAL MEDICINE
  • Facility Address: 3533 SOUTHERN BLVD SUITE 3750
    KETTERING, OH
    ZIP 45429
  • Facility Phone: 937 610-3220
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: ANNETTE BOMBRYS
  • NPI Number: 1770742728
  • Taxonomy: 261QM1200X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 36D1106896
LAB Type Physician Office
Facility Name KETTERING HEALTH MATERNAL FETAL MEDICINE
Street 3533 SOUTHERN BLVD SUITE 3750
City KETTERING
State OH
ZIP 45429
Phone 937 610-3220
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/26/2025
Certificate Expiration Date 8/25/2027
Facility Type Physician Office
Lab Director ANNETTE BOMBRYS

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