36D0344084 CLIA NUMBER - COMMUNITY HEALTH ASSOCIATES FERESHTE KHAVARI MD

Laboratory Demographics

CLIA Number: 36D0344084

Facility Name: COMMUNITY HEALTH ASSOCIATES FERESHTE KHAVARI MD

Facility Address:
120 WEST MAIN STREET
NEW WASHINGTON, OH
ZIP 44854
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Facility Phone Number: 419 492-2200

Facility Type: Physician Office

Certificate Type: Microscopy

NPI Number: 1598077513

Taxonomy: 261QR1300X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	36D0344084
LAB Type	Physician Office
Facility Name	COMMUNITY HEALTH ASSOCIATES FERESHTE KHAVARI MD
Street	120 WEST MAIN STREET
City	NEW WASHINGTON
State	OH
ZIP	44854
Phone	419 492-2200
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