18D2149525 CLIA NUMBER - FORT MITCHELL FIRE DEPARTMENT

Laboratory Demographics

CLIA Number: 18D2149525

Facility Name: FORT MITCHELL FIRE DEPARTMENT

Facility Address:
2355 DIXIE HIGHWAY
FORT MITCHELL, KY
ZIP 41017
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Facility Phone Number: 859 331-1267

Facility Type: Ambulance

Certificate Type: Waiver

NPI Number: 1780683532

Taxonomy: 3416L0300X - Ambulance

CLIA Record

Field Name	Field Value
CLIA Number	18D2149525
LAB Type	Ambulance
Facility Name	FORT MITCHELL FIRE DEPARTMENT
Street	2355 DIXIE HIGHWAY
City	FORT MITCHELL
State	KY
ZIP	41017
Phone	859 331-1267
CertificateType	4
CertificateEffectiveDate	6/5/2022
CertificateExpirationDate	6/4/2024
FacilityType	Waiver

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