36D2070474 CLIA NUMBER - BEAVERCREEK FAMILY HEALTH CENTER LLC

Laboratory Demographics

  • CLIA Code: 36D2070474
  • Facility Name: BEAVERCREEK FAMILY HEALTH CENTER LLC
  • Facility Address: 2633 COMMONS BLVD SUITE 120
    BEAVERCREEK, OH
    ZIP 45431
  • Facility Phone: 937 701-1874
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: PHILIP S. WHITECAR
  • NPI Number: 1407248974
  • Taxonomy: 251300000X - Local Education Agency (LEA)

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CLIA Record

Field Name Field Value
CLIA Number 36D2070474
LAB Type Physician Office
Facility Name BEAVERCREEK FAMILY HEALTH CENTER LLC
Street 2633 COMMONS BLVD SUITE 120
City BEAVERCREEK
State OH
ZIP 45431
Phone 937 701-1874
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 12/18/2023
Certificate Expiration Date 12/17/2025
Facility Type Physician Office
Lab Director PHILIP S. WHITECAR

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