18D1087829 CLIA NUMBER - AIR-EVAC 62

Laboratory Demographics

CLIA Number: 18D1087829

Facility Name: AIR-EVAC 62

Facility Address:
210 3RD AVE STE B
BOWLING GREEN, KY
ZIP 42101
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Facility Phone Number: 270 780-0015

Facility Type: Ambulance

Certificate Type: Waiver

NPI Number: 1306890371

Taxonomy: 3416A0800X - Ambulance

CLIA Record

Field Name	Field Value
CLIA Number	18D1087829
LAB Type	Ambulance
Facility Name	AIR-EVAC 62
Street	210 3RD AVE STE B
City	BOWLING GREEN
State	KY
ZIP	42101
Phone	270 780-0015
CertificateType	4
CertificateEffectiveDate	8/12/2022
CertificateExpirationDate	8/11/2024
FacilityType	Waiver

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This page was last updated on: 4/23/2024