36D2316175 CLIA NUMBER - OWLBRIDGE WELLNESS

Laboratory Demographics

  • CLIA Code: 36D2316175
  • Facility Name: OWLBRIDGE WELLNESS
  • Facility Address: 6730 ROOSEVELT AVENUE, SUITE 201
    MIDDLETOWN, OH
    ZIP 45005
  • Facility Phone: 513 279-8035
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: IRFAN DAHAR
  • NPI Number: 1518587997
  • Taxonomy: 363LP0808X - Nurse Practitioner

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CLIA Record

Field Name Field Value
CLIA Number 36D2316175
LAB Type Physician Office
Facility Name OWLBRIDGE WELLNESS
Street 6730 ROOSEVELT AVENUE, SUITE 201
City MIDDLETOWN
State OH
ZIP 45005
Phone 513 279-8035
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 12/30/2024
Certificate Expiration Date 12/29/2026
Facility Type Physician Office
Lab Director IRFAN DAHAR

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