36D2255096 CLIA NUMBER - HYDE PARK MDVIP

Laboratory Demographics

  • CLIA Code: 36D2255096
  • Facility Name: HYDE PARK MDVIP
  • Facility Address: 3805 EDWARDS ROAD SUITE 360
    CINCINNATI, OH
    ZIP 45209
  • Facility Phone: 513 564-4269
  • Facility Type: Physician Office
  • Facility Type: Microscopy
  • Lab Director: DAVID C. FISHER
  • NPI Number: 1538373923
  • Taxonomy: 314000000X - Skilled Nursing Facility

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CLIA Record

Field Name Field Value
CLIA Number 36D2255096
LAB Type Physician Office
Facility Name HYDE PARK MDVIP
Street 3805 EDWARDS ROAD SUITE 360
City CINCINNATI
State OH
ZIP 45209
Phone 513 564-4269
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 3/10/2024
Certificate Expiration Date 3/9/2026
Facility Type Physician Office
Lab Director DAVID C. FISHER

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