36D2177223 CLIA NUMBER - EMPLOYEE DIRECT CARE SIDNEY MDG BY WILSON HEALTH

Laboratory Demographics

  • CLIA Code: 36D2177223
  • Facility Name: EMPLOYEE DIRECT CARE SIDNEY MDG BY WILSON HEALTH
  • Facility Address: 1079 FAIRINGTON DRIVE
    SIDNEY, OH
    ZIP 45365
  • Facility Phone: 937 419-8015
  • Facility Type: Physician Office
  • Facility Type: Microscopy
  • Lab Director: MICHAEL BEYER
  • NPI Number: 1205886926
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 36D2177223
LAB Type Physician Office
Facility Name EMPLOYEE DIRECT CARE SIDNEY MDG BY WILSON HEALTH
Street 1079 FAIRINGTON DRIVE
City SIDNEY
State OH
ZIP 45365
Phone 937 419-8015
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 1/7/2024
Certificate Expiration Date 1/6/2026
Facility Type Physician Office
Lab Director MICHAEL BEYER

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