36D2264330 CLIA NUMBER - LEO DERMATOLOGY

Laboratory Demographics

  • CLIA Code: 36D2264330
  • Facility Name: LEO DERMATOLOGY
  • Facility Address: 7185 DAYTON SPRINGFIELD RD
    ENON, OH
    ZIP 45323
  • Facility Phone: 937 863-0083
  • Facility Type: Practitioner Other
  • Facility Type: Waiver
  • Lab Director: SHERRY S. GROOMS
  • NPI Number: 1356683999
  • Taxonomy: 207N00000X - Dermatology

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CLIA Record

Field Name Field Value
CLIA Number 36D2264330
LAB Type Practitioner Other
Facility Name LEO DERMATOLOGY
Street 7185 DAYTON SPRINGFIELD RD
City ENON
State OH
ZIP 45323
Phone 937 863-0083
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 7/13/2024
Certificate Expiration Date 7/12/2026
Facility Type Practitioner Other
Lab Director SHERRY S. GROOMS

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