36D2266913 CLIA NUMBER - GOOD SAMARITAN FACULTY MEDICAL CENTER INTERNAL MEDICINE

Laboratory Demographics

  • CLIA Code: 36D2266913
  • Facility Name: GOOD SAMARITAN FACULTY MEDICAL CENTER INTERNAL MEDICINE
  • Facility Address: 375 DIXMYTH AVE 5TH FLOOR
    CINCINNATI, OH
    ZIP 45220
  • Facility Phone: 513 862-1800
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: ANGEL J. MENA
  • NPI Number: 1497842991
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 36D2266913
LAB Type Physician Office
Facility Name GOOD SAMARITAN FACULTY MEDICAL CENTER INTERNAL MEDICINE
Street 375 DIXMYTH AVE 5TH FLOOR
City CINCINNATI
State OH
ZIP 45220
Phone 513 862-1800
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/17/2024
Certificate Expiration Date 8/16/2026
Facility Type Physician Office
Lab Director ANGEL J. MENA

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