36D2179433 CLIA NUMBER - HEALTHCARE 12

Laboratory Demographics

  • CLIA Code: 36D2179433
  • Facility Name: HEALTHCARE 12
  • Facility Address: 2181 VICTORY PARKWAY, 2ND FLOOR
    CINCINNATI, OH
    ZIP 45206
  • Facility Phone: 513 241-2123
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: GEARLINE MONHOLLEN
  • NPI Number: 1255714838
  • Taxonomy: 251K00000X - Public Health or Welfare

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CLIA Record

Field Name Field Value
CLIA Number 36D2179433
LAB Type Physician Office
Facility Name HEALTHCARE 12
Street 2181 VICTORY PARKWAY, 2ND FLOOR
City CINCINNATI
State OH
ZIP 45206
Phone 513 241-2123
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 2/24/2024
Certificate Expiration Date 2/23/2026
Facility Type Physician Office
Lab Director GEARLINE MONHOLLEN

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