36D0327482 CLIA NUMBER - OGLE FAMILY PRACTICE

Laboratory Demographics

CLIA Number: 36D0327482

Facility Name: OGLE FAMILY PRACTICE

Facility Address:
206 SOUTH MULBERRY STREET
MOUNT VERNON, OH
ZIP 43050
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Facility Phone Number: 740 397-3553

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1215063631

Taxonomy: 207Q00000X - Family Medicine
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.

CLIA Record

Field Name	Field Value
CLIA Number	36D0327482
LAB Type	Physician Office
Facility Name	OGLE FAMILY PRACTICE
Street	206 SOUTH MULBERRY STREET
City	MOUNT VERNON
State	OH
ZIP	43050
Phone	740 397-3553
CertificateType	4
CertificateEffectiveDate	2/16/2024
CertificateExpirationDate	2/15/2026
FacilityType	Waiver

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