36D2294752 CLIA NUMBER - HALCYONMD

Laboratory Demographics

  • CLIA Code: 36D2294752
  • Facility Name: HALCYONMD
  • Facility Address: 10123 ALLIANCE RD SUITE 130
    CINCINNATI, OH
    ZIP 45242
  • Facility Phone: 513 530-1348
  • Facility Type: Other - MULTI-SPECIALTY CLINIC
  • Facility Type: Waiver
  • Lab Director: IRA KAUFMAN
  • NPI Number: 1538867031
  • Taxonomy: 261QM1300X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 36D2294752
LAB Type Other - MULTI-SPECIALTY CLINIC
Facility Name HALCYONMD
Street 10123 ALLIANCE RD SUITE 130
City CINCINNATI
State OH
ZIP 45242
Phone 513 530-1348
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 11/29/2023
Certificate Expiration Date 11/28/2025
Facility Type Other - MULTI-SPECIALTY CLINIC
Lab Director IRA KAUFMAN

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