36D2142138 CLIA NUMBER - WRIGHT STATE PHYSICIANS, INC

Laboratory Demographics

  • CLIA Code: 36D2142138
  • Facility Name: WRIGHT STATE PHYSICIANS, INC
  • Facility Address: 725 UNIVERSITY BLVD
    FAIRBORN, OH
    ZIP 45324
  • Facility Phone: 937 245-7200
  • Facility Type: Physician Office
  • Facility Type: Microscopy
  • Lab Director: HARMINDER GREWAL
  • NPI Number: 1316188147
  • Taxonomy: 208600000X - Surgery

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CLIA Record

Field Name Field Value
CLIA Number 36D2142138
LAB Type Physician Office
Facility Name WRIGHT STATE PHYSICIANS, INC
Street 725 UNIVERSITY BLVD
City FAIRBORN
State OH
ZIP 45324
Phone 937 245-7200
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 1/4/2024
Certificate Expiration Date 1/3/2026
Facility Type Physician Office
Lab Director HARMINDER GREWAL

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