36D2112407 CLIA NUMBER - KETTERING HEALTH MEDICAL GROUP OB-GYN

Laboratory Demographics

  • CLIA Code: 36D2112407
  • Facility Name: KETTERING HEALTH MEDICAL GROUP OB-GYN
  • Facility Address: 1989 MIAMISBURG CENTERVILLE RD, STE 100
    DAYTON, OH
    ZIP 45459
  • Facility Phone: 937 439-5252
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: WILLIAM R. DORSEY
  • NPI Number: 1588695688
  • Taxonomy: 225100000X - Physical Therapist

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CLIA Record

Field Name Field Value
CLIA Number 36D2112407
LAB Type Physician Office
Facility Name KETTERING HEALTH MEDICAL GROUP OB-GYN
Street 1989 MIAMISBURG CENTERVILLE RD, STE 100
City DAYTON
State OH
ZIP 45459
Phone 937 439-5252
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/28/2024
Certificate Expiration Date 4/27/2026
Facility Type Physician Office
Lab Director WILLIAM R. DORSEY

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