CLIA lab
CLIA 36D2124438: Licking Memorial Family Practice Hebron
Hebron, OH. Certificate and address details from the CMS Provider of Services file for clinical laboratories.
CLIA number 36D2124438 belongs to Licking Memorial Family Practice Hebron in Hebron, OH.
Certificate of Waiver, effective April 6, 2025, expires April 5, 2027.
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
- April 6, 2025
- Certificate expiration
- April 5, 2027
- Status in the CMS file
- Active (termination code 00)
- Original participation date
- January 17, 2017
- Facility type
- Physician office
- Ownership (control type)
- Private
- Lab classification
- CLIA laboratory
- Directly affiliated labs
- 3
Source: CMS Provider of Services File, Clinical Laboratories (CLIA), as of October 16, 2026. Publisher page
Lab and contact
- CLIA number
- 36D2124438
- Lab name
- Licking Memorial Family Practice Hebron
- Address
- 96 Integrity Drive, Suite H, Hebron, OH 43025
- Phone
- (220) 564-2100
- Fax
- (220) 564-2101
Annual test volume the lab reported
- Waived tests
- 500
Volumes are what the lab reported to CMS on its CMS-116 application, as carried in the file.
Affiliated CLIA numbers
Other labs in Hebron, OH
Related
Questions
What is the CLIA number for Licking Memorial Family Practice Hebron in Hebron?
36D2124438, per the CMS Provider of Services file posted October 16, 2026.
What CLIA certificate does Licking Memorial Family Practice Hebron hold?
A Certificate of Waiver, according to the CMS file.
When does CLIA 36D2124438 expire?
The CMS file lists April 5, 2027 as the certificate expiration date; the certificate took effect April 6, 2025.