36D0682477 CLIA NUMBER - HOLZER HOSPITAL FOUNDATION DBA HOLZER JACKSON

Laboratory Demographics

  • CLIA Code: 36D0682477
  • Facility Name: HOLZER HOSPITAL FOUNDATION DBA HOLZER JACKSON
  • Facility Address: 280 PATTONSVLLE ROAD
    JACKSON, OH
    ZIP 45640
  • Facility Phone: 740 446-5171
  • Facility Type: Physician Office
  • Facility Type: Accreditation
  • Lab Director: DR. RAUL J. GAGUCAS
  • NPI Number: 1629109780
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 36D0682477
LAB Type Physician Office
Facility Name HOLZER HOSPITAL FOUNDATION DBA HOLZER JACKSON
Street 280 PATTONSVLLE ROAD
City JACKSON
State OH
ZIP 45640
Phone 740 446-5171
Certificate Type Certificate of Accreditation
Certificate Type Description This is a certificate that is issued to a laboratory on the basis of the laboratory's accreditation by an accreditation organization approved by CMS.
Certificate Effective Date 12/23/2023
Certificate Expiration Date 12/22/2025
Facility Type Physician Office
Lab Director DR. RAUL J. GAGUCAS

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This page was last updated on: 9/29/2025