36D2328874 CLIA NUMBER - MEDONE PRIMARY CARE

Laboratory Demographics

  • CLIA Code: 36D2328874
  • Facility Name: MEDONE PRIMARY CARE
  • Facility Address: 55 DILLMONT DRIVE, SUITE 102
    COLUMBUS, OH
    ZIP 43235
  • Facility Phone: 614 255-6900
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: SENTHURAN T. SIVA
  • NPI Number: 1003638644
  • Taxonomy: 174400000X - Specialist

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CLIA Record

Field Name Field Value
CLIA Number 36D2328874
LAB Type Physician Office
Facility Name MEDONE PRIMARY CARE
Street 55 DILLMONT DRIVE, SUITE 102
City COLUMBUS
State OH
ZIP 43235
Phone 614 255-6900
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/19/2025
Certificate Expiration Date 8/18/2027
Facility Type Physician Office
Lab Director SENTHURAN T. SIVA

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