36D2324139 CLIA NUMBER - MIDWEST INTEGRATED CARE

Laboratory Demographics

  • CLIA Code: 36D2324139
  • Facility Name: MIDWEST INTEGRATED CARE
  • Facility Address: 775 WEST BROAD STREET, SUITE 260
    COLUMBUS, OH
    ZIP 43222
  • Facility Phone: 614 767-9538
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: GITI MAYTON
  • NPI Number: 1083406482
  • Taxonomy: 261QM0801X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 36D2324139
LAB Type Physician Office
Facility Name MIDWEST INTEGRATED CARE
Street 775 WEST BROAD STREET, SUITE 260
City COLUMBUS
State OH
ZIP 43222
Phone 614 767-9538
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 5/20/2025
Certificate Expiration Date 5/19/2027
Facility Type Physician Office
Lab Director GITI MAYTON

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