36D2312139 CLIA NUMBER - PETIT DERMATOLOGY LLC

Laboratory Demographics

  • CLIA Code: 36D2312139
  • Facility Name: PETIT DERMATOLOGY LLC
  • Facility Address: 6770 CINCINNATI DAYTON ROAD SUITE 200
    LIBERTY TOWNSHIP, OH
    ZIP 45044
  • Facility Phone: 513 276-4981
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: DANIELLE PETIT
  • NPI Number: 1447096540
  • Taxonomy: 207N00000X - Dermatology

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CLIA Record

Field Name Field Value
CLIA Number 36D2312139
LAB Type Physician Office
Facility Name PETIT DERMATOLOGY LLC
Street 6770 CINCINNATI DAYTON ROAD SUITE 200
City LIBERTY TOWNSHIP
State OH
ZIP 45044
Phone 513 276-4981
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/4/2024
Certificate Expiration Date 10/3/2026
Facility Type Physician Office
Lab Director DANIELLE PETIT

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