36D0327508 CLIA NUMBER - KNOX COUNTY HEALTH DEPARTMENT

Laboratory Demographics

CLIA Number: 36D0327508

Facility Name: KNOX COUNTY HEALTH DEPARTMENT

Facility Address:
11660 UPPER GILCHRIST ROAD
MOUNT VERNON, OH
ZIP 43050
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Facility Phone Number: 740 392-2200

Facility Type: Federally Qualified Health Center

Certificate Type: Microscopy

NPI Number: 1760955975

Taxonomy: 261QF0400X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	36D0327508
LAB Type	Federally Qualified Health Center
Facility Name	KNOX COUNTY HEALTH DEPARTMENT
Street	11660 UPPER GILCHRIST ROAD
City	MOUNT VERNON
State	OH
ZIP	43050
Phone	740 392-2200
CertificateType	3
CertificateEffectiveDate	9/1/2022
CertificateExpirationDate	8/31/2024
FacilityType	PPMP

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