36D2155330 CLIA NUMBER - CENTRAL OHIO GERIATRICS KG

Laboratory Demographics

  • CLIA Code: 36D2155330
  • Facility Name: CENTRAL OHIO GERIATRICS KG
  • Facility Address: 2158 COLUMBUS ROAD
    GRANVILLE, OH
    ZIP 43023
  • Facility Phone: 740 920-4336
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: JOHN M. WEIGAND
  • NPI Number: 1073753794
  • Taxonomy: 207RG0300X - Internal Medicine

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CLIA Record

Field Name Field Value
CLIA Number 36D2155330
LAB Type Physician Office
Facility Name CENTRAL OHIO GERIATRICS KG
Street 2158 COLUMBUS ROAD
City GRANVILLE
State OH
ZIP 43023
Phone 740 920-4336
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/27/2024
Certificate Expiration Date 9/26/2026
Facility Type Physician Office
Lab Director JOHN M. WEIGAND

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