25D2179437 CLIA NUMBER - PHI AIR MEDICAL

Laboratory Demographics

CLIA Number: 25D2179437

Facility Name: PHI AIR MEDICAL

Facility Address:
368-A FABRITEK DRIVE
COLUMBUS, MS
ZIP 39702
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Facility Phone Number: 480 263-1611

Facility Type: Ambulance

Certificate Type: Waiver

NPI Number: 1760003594

Taxonomy: 3416A0800X - Ambulance

CLIA Record

Field Name	Field Value
CLIA Number	25D2179437
LAB Type	Ambulance
Facility Name	PHI AIR MEDICAL
Street	368-A FABRITEK DRIVE
City	COLUMBUS
State	MS
ZIP	39702
Phone	480 263-1611
CertificateType	4
CertificateEffectiveDate	2/24/2024
CertificateExpirationDate	2/23/2026
FacilityType	Waiver

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