36D2254561 CLIA NUMBER - OHIODERM HOLDINGS, INC

Laboratory Demographics

  • CLIA Code: 36D2254561
  • Facility Name: OHIODERM HOLDINGS, INC
  • Facility Address: 2200 TIMBER TRAIL
    BELLEFONTAINE, OH
    ZIP 43311
  • Facility Phone: 937 595-0100
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: DR. MICHAEL P. CONROY
  • NPI Number: 1174206791
  • Taxonomy: 207ND0900X - Dermatology

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CLIA Record

Field Name Field Value
CLIA Number 36D2254561
LAB Type Physician Office
Facility Name OHIODERM HOLDINGS, INC
Street 2200 TIMBER TRAIL
City BELLEFONTAINE
State OH
ZIP 43311
Phone 937 595-0100
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/17/2024
Certificate Expiration Date 10/16/2026
Facility Type Physician Office
Lab Director DR. MICHAEL P. CONROY

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