36D2174436 CLIA NUMBER - MARATHON HEALTH AT GREEN TOWNSHIP

Laboratory Demographics

  • CLIA Code: 36D2174436
  • Facility Name: MARATHON HEALTH AT GREEN TOWNSHIP
  • Facility Address: 6355 HARRISON AVENUE SUITE 8
    CINCINNATI, OH
    ZIP 45248
  • Facility Phone: 866 434-3255
  • Facility Type: Physician Office
  • Facility Type: Microscopy
  • Lab Director: PAUL WALLER
  • NPI Number: 1710608070
  • Taxonomy: 363LF0000X - Nurse Practitioner

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CLIA Record

Field Name Field Value
CLIA Number 36D2174436
LAB Type Physician Office
Facility Name MARATHON HEALTH AT GREEN TOWNSHIP
Street 6355 HARRISON AVENUE SUITE 8
City CINCINNATI
State OH
ZIP 45248
Phone 866 434-3255
Certificate Type Certificate for Provider-Performed Microscopy Procedures (PPMP)
Certificate Type Description This certificate is issued to a laboratory in which a physician, midlevel practitioner or dentist performs no tests other than the microscopy procedures. This certificate permits the laboratory to also perform waived tests.
Certificate Effective Date 10/31/2023
Certificate Expiration Date 10/30/2025
Facility Type Physician Office
Lab Director PAUL WALLER

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