36D2287242 CLIA NUMBER - HINES PRIMARY CARE

Laboratory Demographics

  • CLIA Code: 36D2287242
  • Facility Name: HINES PRIMARY CARE
  • Facility Address: 1 NORTH COMMERCE PARK DRIVE SUITE 221
    CINCINNATI, OH
    ZIP 45215
  • Facility Phone: 513 485-0750
  • Facility Type: Practitioner Other
  • Facility Type: Waiver
  • Lab Director: CHARLENE T. HINES
  • NPI Number: 1366130098
  • Taxonomy: 363LP2300X - Nurse Practitioner

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CLIA Record

Field Name Field Value
CLIA Number 36D2287242
LAB Type Practitioner Other
Facility Name HINES PRIMARY CARE
Street 1 NORTH COMMERCE PARK DRIVE SUITE 221
City CINCINNATI
State OH
ZIP 45215
Phone 513 485-0750
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/11/2025
Certificate Expiration Date 8/10/2027
Facility Type Practitioner Other
Lab Director CHARLENE T. HINES

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