36D2036210 CLIA NUMBER - FIVE RIVERS HEALTH CENTERS EDGEMONT

Laboratory Demographics

  • CLIA Code: 36D2036210
  • Facility Name: FIVE RIVERS HEALTH CENTERS EDGEMONT
  • Facility Address: 721 MIAMI CHAPEL ROAD
    DAYTON, OH
    ZIP 45417
  • Facility Phone: 937 734-4141
  • Facility Type: Federally Qualified Health Center
  • Facility Type: Microscopy
  • Lab Director: MAMLE ANIM
  • NPI Number: 1497190771
  • Taxonomy: 3336C0002X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 36D2036210
LAB Type Federally Qualified Health Center
Facility Name FIVE RIVERS HEALTH CENTERS EDGEMONT
Street 721 MIAMI CHAPEL ROAD
City DAYTON
State OH
ZIP 45417
Phone 937 734-4141
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 2/3/2024
Certificate Expiration Date 2/2/2026
Facility Type Federally Qualified Health Center
Lab Director MAMLE ANIM

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