36D2157603 CLIA NUMBER - KETTERING HEALTH MEDICAL GROUP PRIMARY CARE

Laboratory Demographics

  • CLIA Code: 36D2157603
  • Facility Name: KETTERING HEALTH MEDICAL GROUP PRIMARY CARE
  • Facility Address: 450B WASHINGTON JACKSON RD, STE 105
    EATON, OH
    ZIP 45320
  • Facility Phone: 937 456-8350
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: JILL B. VOSLER
  • NPI Number: 1467090670
  • Taxonomy: 261QR1300X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 36D2157603
LAB Type Physician Office
Facility Name KETTERING HEALTH MEDICAL GROUP PRIMARY CARE
Street 450B WASHINGTON JACKSON RD, STE 105
City EATON
State OH
ZIP 45320
Phone 937 456-8350
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 11/8/2024
Certificate Expiration Date 11/7/2026
Facility Type Physician Office
Lab Director JILL B. VOSLER

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