36D2162066 CLIA NUMBER - OHIO ARMY NATIONAL GUARD MEDICAL DETACHMENT

Laboratory Demographics

  • CLIA Code: 36D2162066
  • Facility Name: OHIO ARMY NATIONAL GUARD MEDICAL DETACHMENT
  • Facility Address: 3990 EAST BROAD STREET BLDG 11, SECTION 11
    COLUMBUS, OH
    ZIP 43213
  • Facility Phone: 614 336-7240
  • Facility Type: Other - MILITARY CLINIC
  • Facility Type: Waiver
  • Lab Director: BRETT A. CALL
  • NPI Number: 1598175010
  • Taxonomy: 251S00000X - Community/Behavioral Health

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 36D2162066
LAB Type Other - MILITARY CLINIC
Facility Name OHIO ARMY NATIONAL GUARD MEDICAL DETACHMENT
Street 3990 EAST BROAD STREET BLDG 11, SECTION 11
City COLUMBUS
State OH
ZIP 43213
Phone 614 336-7240
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 2/15/2025
Certificate Expiration Date 2/14/2027
Facility Type Other - MILITARY CLINIC
Lab Director BRETT A. CALL

Download Record

Download this CLIA record record in Text format: Export

Download this CLIA record record in Excel (CSV) format: Export

Download this CLIA record record in XML format: Export

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