36D0720443 CLIA NUMBER - JEFFERSON TOWNSHIP FIRE DEPARTMENT ATTN PAUL ZEEB MD

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Laboratory Demographics

CLIA Number: 36D0720443

Facility Name: JEFFERSON TOWNSHIP FIRE DEPARTMENT ATTN PAUL ZEEB MD

Facility Address:
6767 HAVENS CORNER ROAD
BLACKLICK, OH
ZIP 43004
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Facility Phone Number: 614 861-3757

Facility Type: Other

Certificate Type: Waiver

NPI Number: 1275525131

Taxonomy: 3416L0300X - Ambulance

CLIA Record

Field Name	Field Value
CLIA Number	36D0720443
LAB Type	Other
Facility Name	JEFFERSON TOWNSHIP FIRE DEPARTMENT ATTN PAUL ZEEB MD
Street	6767 HAVENS CORNER ROAD
City	BLACKLICK
State	OH
ZIP	43004
Phone	614 861-3757
CertificateType	4
CertificateEffectiveDate	9/1/2022
CertificateExpirationDate	8/31/2024
FacilityType	Waiver

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