36D2271804 CLIA NUMBER - DIVINE INTERVENTION RECOVERY CENTER

Laboratory Demographics

  • CLIA Code: 36D2271804
  • Facility Name: DIVINE INTERVENTION RECOVERY CENTER
  • Facility Address: 7373 DAYTON SPRINGFIELD RD
    ENON, OH
    ZIP 45323
  • Facility Phone: 937 862-0008
  • Facility Type: Community Clinic
  • Facility Type: Waiver
  • Lab Director: FAYE J. BARRON
  • NPI Number: 1629756176
  • Taxonomy: 251S00000X - Community/Behavioral Health

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 36D2271804
LAB Type Community Clinic
Facility Name DIVINE INTERVENTION RECOVERY CENTER
Street 7373 DAYTON SPRINGFIELD RD
City ENON
State OH
ZIP 45323
Phone 937 862-0008
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 11/8/2024
Certificate Expiration Date 11/7/2026
Facility Type Community Clinic
Lab Director FAYE J. BARRON

Download Record

Download this CLIA record record in Text format: Export

Download this CLIA record record in Excel (CSV) format: Export

Download this CLIA record record in XML format: Export

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