36D2143529 CLIA NUMBER - BETHESDA HOSPITAL ALCOHOL & DRUG TREATMENT PROGRAM

Laboratory Demographics

  • CLIA Code: 36D2143529
  • Facility Name: BETHESDA HOSPITAL ALCOHOL & DRUG TREATMENT PROGRAM
  • Facility Address: 4410 CARVER WOODS DRIVE, SUITE 206
    CINCINNATI, OH
    ZIP 45242
  • Facility Phone: 513 489-6011
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: ISMAIL A. BADRAN
  • NPI Number: 1649365412
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 36D2143529
LAB Type Physician Office
Facility Name BETHESDA HOSPITAL ALCOHOL & DRUG TREATMENT PROGRAM
Street 4410 CARVER WOODS DRIVE, SUITE 206
City CINCINNATI
State OH
ZIP 45242
Phone 513 489-6011
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/13/2024
Certificate Expiration Date 9/12/2026
Facility Type Physician Office
Lab Director ISMAIL A. BADRAN

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