36D2228035 CLIA NUMBER - KETTERING HEALTH MEDICAL GROUP BRAIN AND SPINE

Laboratory Demographics

  • CLIA Code: 36D2228035
  • Facility Name: KETTERING HEALTH MEDICAL GROUP BRAIN AND SPINE
  • Facility Address: 1 KETTERING WAY, SUITE 200
    PIQUA, OH
    ZIP 45356
  • Facility Phone: 937 643-9299
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: DANIEL VERRILL
  • NPI Number: 1346791712
  • Taxonomy: 363LF0000X - Nurse Practitioner

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 36D2228035
LAB Type Physician Office
Facility Name KETTERING HEALTH MEDICAL GROUP BRAIN AND SPINE
Street 1 KETTERING WAY, SUITE 200
City PIQUA
State OH
ZIP 45356
Phone 937 643-9299
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 6/21/2025
Certificate Expiration Date 6/20/2027
Facility Type Physician Office
Lab Director DANIEL VERRILL

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