36D2248780 CLIA NUMBER - WHITAKER DIRECT PRIMARY CARE

Laboratory Demographics

  • CLIA Code: 36D2248780
  • Facility Name: WHITAKER DIRECT PRIMARY CARE
  • Facility Address: 104 N MAIN ST SUITE A
    ARCANUM, OH
    ZIP 45304
  • Facility Phone: 937 662-0181
  • Facility Type: Physician Office
  • Facility Type: Microscopy
  • Lab Director: ABBY M. WHITAKER
  • NPI Number: 1609695378
  • Taxonomy: 363LF0000X - Nurse Practitioner

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CLIA Record

Field Name Field Value
CLIA Number 36D2248780
LAB Type Physician Office
Facility Name WHITAKER DIRECT PRIMARY CARE
Street 104 N MAIN ST SUITE A
City ARCANUM
State OH
ZIP 45304
Phone 937 662-0181
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 1/17/2024
Certificate Expiration Date 1/16/2026
Facility Type Physician Office
Lab Director ABBY M. WHITAKER

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