CLIA lab
CLIA 36D0894689: Providence Medical Group DBA
Bellbrook, OH. Certificate and address details from the CMS Provider of Services file for clinical laboratories.
CLIA number 36D0894689 belongs to Providence Medical Group DBA in Bellbrook, OH.
Certificate for Provider-Performed Microscopy Procedures, effective November 19, 2024, expires November 18, 2026.
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 for Provider-Performed Microscopy Procedures
- Certificate effective
- November 19, 2024
- Certificate expiration
- November 18, 2026
- Status in the CMS file
- Active (termination code 00)
- Original participation date
- November 19, 1994
- 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
- 36D0894689
- Lab name
- Providence Medical Group DBA
- Additional name
- Sugarcreek Family Medicine
- Address
- 4403 State Rte 725 Ste D, Bellbrook, OH 45305
- Phone
- (937) 848-9010
- Fax
- (937) 848-9017
Annual test volume the lab reported
- Waived tests
- 400
- Provider-performed microscopy tests
- 600
- Total
- 1,000
Volumes are what the lab reported to CMS on its CMS-116 application, as carried in the file.
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Related
Questions
What is the CLIA number for Providence Medical Group DBA in Bellbrook?
36D0894689, per the CMS Provider of Services file posted October 16, 2026.
What CLIA certificate does Providence Medical Group DBA hold?
A Certificate for Provider-Performed Microscopy Procedures, according to the CMS file.
When does CLIA 36D0894689 expire?
The CMS file lists November 18, 2026 as the certificate expiration date; the certificate took effect November 19, 2024.