36D2104486 CLIA NUMBER - IDOX3 LLC

Laboratory Demographics

  • CLIA Code: 36D2104486
  • Facility Name: IDOX3 LLC
  • Facility Address: 405 SOUTH 3RD STREET
    IRONTON, OH
    ZIP 45638
  • Facility Phone: 606 324-2451
  • Facility Type: Ambulatory Surgery Center
  • Facility Type: Waiver
  • Lab Director: CARTER GUSSLER
  • NPI Number: 1417333295
  • Taxonomy: 261QA1903X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 36D2104486
LAB Type Ambulatory Surgery Center
Facility Name IDOX3 LLC
Street 405 SOUTH 3RD STREET
City IRONTON
State OH
ZIP 45638
Phone 606 324-2451
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 11/5/2023
Certificate Expiration Date 11/4/2025
Facility Type Ambulatory Surgery Center
Lab Director CARTER GUSSLER

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