36D2321612 CLIA NUMBER - AEG OHIO PROFESSIONAL

Laboratory Demographics

  • CLIA Code: 36D2321612
  • Facility Name: AEG OHIO PROFESSIONAL
  • Facility Address: 1301 CABLE ROAD
    LIMA, OH
    ZIP 45805
  • Facility Phone: 419 227-2020
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: MICHAEL A. FISHBAUGH JR
  • NPI Number: 1780283952
  • Taxonomy: 152W00000X - Optometrist

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 36D2321612
LAB Type Physician Office
Facility Name AEG OHIO PROFESSIONAL
Street 1301 CABLE ROAD
City LIMA
State OH
ZIP 45805
Phone 419 227-2020
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/7/2025
Certificate Expiration Date 4/6/2027
Facility Type Physician Office
Lab Director MICHAEL A. FISHBAUGH JR

Download Record

Download this CLIA record record in Text format: Export

Download this CLIA record record in Excel (CSV) format: Export

Download this CLIA record record in XML format: Export

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