36D2330029 CLIA NUMBER - WRIGHT STATE UNIVERSITY STUDENT HEALTH SERVICES

Laboratory Demographics

  • CLIA Code: 36D2330029
  • Facility Name: WRIGHT STATE UNIVERSITY STUDENT HEALTH SERVICES
  • Facility Address: 725 UNIVERSITY BLVD
    FAIRBORN, OH
    ZIP 45324
  • Facility Phone: 937 245-7341
  • Facility Type: Physician Office
  • Facility Type: Microscopy
  • Lab Director: MARC RASLICH
  • NPI Number: 1205197985
  • Taxonomy: 207X00000X - Orthopaedic Surgery

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CLIA Record

Field Name Field Value
CLIA Number 36D2330029
LAB Type Physician Office
Facility Name WRIGHT STATE UNIVERSITY STUDENT HEALTH SERVICES
Street 725 UNIVERSITY BLVD
City FAIRBORN
State OH
ZIP 45324
Phone 937 245-7341
Certificate Type Certificate for Provider-Performed Microscopy Procedures (PPMP)
Certificate Type Description This certificate is issued to a laboratory in which a physician, midlevel practitioner or dentist performs no tests other than the microscopy procedures. This certificate permits the laboratory to also perform waived tests.
Certificate Effective Date 9/9/2025
Certificate Expiration Date 9/8/2027
Facility Type Physician Office
Lab Director MARC RASLICH

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