36D2005093 CLIA NUMBER - DEERFIELD PRIMARY CARE & SPECIALTY PHYSICIANS MMA

Laboratory Demographics

  • CLIA Code: 36D2005093
  • Facility Name: DEERFIELD PRIMARY CARE & SPECIALTY PHYSICIANS MMA
  • Facility Address: 5232 SOCIALVILLE-FOSTER ROAD
    MASON, OH
    ZIP 45040
  • Facility Phone: 513 339-0800
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: MICHAEL TROMBLEY
  • NPI Number: 1336179308
  • Taxonomy: 2085R0202X - Radiology

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CLIA Record

Field Name Field Value
CLIA Number 36D2005093
LAB Type Physician Office
Facility Name DEERFIELD PRIMARY CARE & SPECIALTY PHYSICIANS MMA
Street 5232 SOCIALVILLE-FOSTER ROAD
City MASON
State OH
ZIP 45040
Phone 513 339-0800
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/1/2024
Certificate Expiration Date 2/28/2026
Facility Type Physician Office
Lab Director MICHAEL TROMBLEY

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