36D2294444 CLIA NUMBER - JYOTHI PURAM MD, INC DBA HEALTHY LIFE PRIMARY CARE

Laboratory Demographics

  • CLIA Code: 36D2294444
  • Facility Name: JYOTHI PURAM MD, INC DBA HEALTHY LIFE PRIMARY CARE
  • Facility Address: 1176 E HOME RD
    SPRINGFIELD, OH
    ZIP 45503
  • Facility Phone: 567 343-1966
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: JANICE SIZEMORE
  • NPI Number: 1013000926
  • Taxonomy: 207R00000X - Internal Medicine

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CLIA Record

Field Name Field Value
CLIA Number 36D2294444
LAB Type Physician Office
Facility Name JYOTHI PURAM MD, INC DBA HEALTHY LIFE PRIMARY CARE
Street 1176 E HOME RD
City SPRINGFIELD
State OH
ZIP 45503
Phone 567 343-1966
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 11/27/2023
Certificate Expiration Date 11/26/2025
Facility Type Physician Office
Lab Director JANICE SIZEMORE

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