36D2041694 CLIA NUMBER - OHIO PEDIATRIC RESEARCH ASSOCIATION

Laboratory Demographics

  • CLIA Code: 36D2041694
  • Facility Name: OHIO PEDIATRIC RESEARCH ASSOCIATION
  • Facility Address: 7200 POE AVENUE SUITE 200
    DAYTON, OH
    ZIP 45414
  • Facility Phone: 937 424-9294
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: MARK SHEPARD
  • NPI Number: 1699921932
  • Taxonomy: 208000000X - Pediatrics

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CLIA Record

Field Name Field Value
CLIA Number 36D2041694
LAB Type Physician Office
Facility Name OHIO PEDIATRIC RESEARCH ASSOCIATION
Street 7200 POE AVENUE SUITE 200
City DAYTON
State OH
ZIP 45414
Phone 937 424-9294
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 5/29/2024
Certificate Expiration Date 5/28/2026
Facility Type Physician Office
Lab Director MARK SHEPARD

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