36D2308862 CLIA NUMBER - CENTERVILLE PRIMARY CARE

Laboratory Demographics

  • CLIA Code: 36D2308862
  • Facility Name: CENTERVILLE PRIMARY CARE
  • Facility Address: 6555 CLYO ROAD
    CENTERVILLE, OH
    ZIP 45459
  • Facility Phone: 937 610-1121
  • Facility Type: Prison
  • Facility Type: Waiver
  • Lab Director: JOHN MOREHOUS
  • NPI Number: 1750438172
  • Taxonomy: 152W00000X - Optometrist

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CLIA Record

Field Name Field Value
CLIA Number 36D2308862
LAB Type Prison
Facility Name CENTERVILLE PRIMARY CARE
Street 6555 CLYO ROAD
City CENTERVILLE
State OH
ZIP 45459
Phone 937 610-1121
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/6/2024
Certificate Expiration Date 8/5/2026
Facility Type Prison
Lab Director JOHN MOREHOUS

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