36D2254272 CLIA NUMBER - GU OHIO, LLC

Laboratory Demographics

  • CLIA Code: 36D2254272
  • Facility Name: GU OHIO, LLC
  • Facility Address: 1225 WOODLAWN AVENUE, STE 114
    CAMBRIDGE, OH
    ZIP 43725
  • Facility Phone: 740 255-5189
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: DR. BENJAMIN R. GIBSON
  • NPI Number: 1871248740
  • Taxonomy: 208800000X - Urology

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CLIA Record

Field Name Field Value
CLIA Number 36D2254272
LAB Type Physician Office
Facility Name GU OHIO, LLC
Street 1225 WOODLAWN AVENUE, STE 114
City CAMBRIDGE
State OH
ZIP 43725
Phone 740 255-5189
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/2/2024
Certificate Expiration Date 3/1/2026
Facility Type Physician Office
Lab Director DR. BENJAMIN R. GIBSON

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This page was last updated on: 6/4/2025