36D0348203 CLIA NUMBER - STUDEBAKER FAMILY PRACTICE

Laboratory Demographics

  • CLIA Code: 36D0348203
  • Facility Name: STUDEBAKER FAMILY PRACTICE
  • Facility Address: 98 MOSIER PARKWAY
    BROOKVILLE, OH
    ZIP 45309
  • Facility Phone: 937 833-4103
  • Facility Type: Physician Office
  • Facility Type: Microscopy
  • Lab Director: ERICA L. BROWN
  • NPI Number: 1609081314
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 36D0348203
LAB Type Physician Office
Facility Name STUDEBAKER FAMILY PRACTICE
Street 98 MOSIER PARKWAY
City BROOKVILLE
State OH
ZIP 45309
Phone 937 833-4103
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 2/6/2024
Certificate Expiration Date 2/5/2026
Facility Type Physician Office
Lab Director ERICA L. BROWN

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This page was last updated on: 6/4/2025