36D2105580 CLIA NUMBER - MOUNT CARMEL CARDIOVASCULAR IMAGING SERVICES AT LEWIS CENTER

Laboratory Demographics

  • CLIA Code: 36D2105580
  • Facility Name: MOUNT CARMEL CARDIOVASCULAR IMAGING SERVICES AT LEWIS CENTER
  • Facility Address: 7100 GRAPHICS WAY SUITE 1550
    LEWIS CENTER, OH
    ZIP 43035
  • Facility Phone: 937 408-1314
  • Facility Type: Ancillary Testing Site in Health Care Center
  • Facility Type: Waiver
  • Lab Director: FRANK D. TICE
  • NPI Number: 1699131144
  • Taxonomy: 261QX0100X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 36D2105580
LAB Type Ancillary Testing Site in Health Care Center
Facility Name MOUNT CARMEL CARDIOVASCULAR IMAGING SERVICES AT LEWIS CENTER
Street 7100 GRAPHICS WAY SUITE 1550
City LEWIS CENTER
State OH
ZIP 43035
Phone 937 408-1314
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 12/1/2023
Certificate Expiration Date 11/30/2025
Facility Type Ancillary Testing Site in Health Care Center
Lab Director FRANK D. TICE

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