CLIA lab
CLIA 36D0717102: Costin Family Practice Inc
Bellefontaine, OH. Certificate and address details from the CMS Provider of Services file for clinical laboratories.
CLIA number 36D0717102 belongs to Costin Family Practice Inc in Bellefontaine, OH.
Certificate of Waiver, effective June 1, 2026, expires May 31, 2028.
Active in the CMS Provider of Services file posted October 16, 2026.
Source: CMS Provider of Services File, Clinical Laboratories (CLIA), as of October 16, 2026. Publisher page
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Certificate
- Certificate type
- Certificate of Waiver
- Certificate effective
- June 1, 2026
- Certificate expiration
- May 31, 2028
- Status in the CMS file
- Active (termination code 00)
- Original participation date
- September 1, 1992
- Facility type
- Physician office
- Ownership (control type)
- Proprietary
- Lab classification
- CLIA laboratory
Source: CMS Provider of Services File, Clinical Laboratories (CLIA), as of October 16, 2026. Publisher page
Lab and contact
- CLIA number
- 36D0717102
- Lab name
- Costin Family Practice Inc
- Address
- 921 East Sandusky Avenue, Bellefontaine, OH 43311
- Phone
- (937) 599-3085
- Fax
- (937) 592-5162
Annual test volume the lab reported
- Waived tests
- 600
Volumes are what the lab reported to CMS on its CMS-116 application, as carried in the file.
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- Community Health & WellnessCertificate for Provider-Performed Microscopy Procedures, Federally qualified health center36D2147414
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- Highpoint Mental Health LLCCertificate of Waiver, Other practitioner36D2319871
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Related
Questions
What is the CLIA number for Costin Family Practice Inc in Bellefontaine?
36D0717102, per the CMS Provider of Services file posted October 16, 2026.
What CLIA certificate does Costin Family Practice Inc hold?
A Certificate of Waiver, according to the CMS file.
When does CLIA 36D0717102 expire?
The CMS file lists May 31, 2028 as the certificate expiration date; the certificate took effect June 1, 2026.