36D2162334 CLIA NUMBER - KETTERING HEALTH DAYTON CANCER CARE SOIN - WAIVED TESTING LAB

Laboratory Demographics

  • CLIA Code: 36D2162334
  • Facility Name: KETTERING HEALTH DAYTON CANCER CARE SOIN - WAIVED TESTING LAB
  • Facility Address: 3535 PENTAGON PARK BLVD SUITE 400, CLA ROOM
    BEAVERCREEK, OH
    ZIP 45431
  • Facility Phone: 937 281-3806
  • Facility Type: Ancillary Testing Site in Health Care Center
  • Facility Type: Waiver
  • Lab Director: JASON MEYER
  • NPI Number: 1730461047
  • Taxonomy: 208600000X - Surgery

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CLIA Record

Field Name Field Value
CLIA Number 36D2162334
LAB Type Ancillary Testing Site in Health Care Center
Facility Name KETTERING HEALTH DAYTON CANCER CARE SOIN - WAIVED TESTING LAB
Street 3535 PENTAGON PARK BLVD SUITE 400, CLA ROOM
City BEAVERCREEK
State OH
ZIP 45431
Phone 937 281-3806
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 2/20/2025
Certificate Expiration Date 2/19/2027
Facility Type Ancillary Testing Site in Health Care Center
Lab Director JASON MEYER

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