36D2123219 CLIA NUMBER - MACHUCA MEDICAL, LLC

Laboratory Demographics

  • CLIA Code: 36D2123219
  • Facility Name: MACHUCA MEDICAL, LLC
  • Facility Address: 7371 BRANDT PIKE, SUITE D
    HUBER HEIGHTS, OH
    ZIP 45424
  • Facility Phone: 937 795-1101
  • Facility Type: Physician Office
  • Facility Type: Microscopy
  • Lab Director: JENNIFER L. MACHUCA
  • NPI Number: 1053861369
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 36D2123219
LAB Type Physician Office
Facility Name MACHUCA MEDICAL, LLC
Street 7371 BRANDT PIKE, SUITE D
City HUBER HEIGHTS
State OH
ZIP 45424
Phone 937 795-1101
Certificate Type Certificate for Provider-Performed Microscopy Procedures (PPMP)
Certificate Type Description This certificate is issued to a laboratory in which a physician, midlevel practitioner or dentist performs no tests other than the microscopy procedures. This certificate permits the laboratory to also perform waived tests.
Certificate Effective Date 12/15/2024
Certificate Expiration Date 12/14/2026
Facility Type Physician Office
Lab Director JENNIFER L. MACHUCA

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