36D0929856 CLIA NUMBER - FAYETTEVILLE FIRE DEPT, INC

Laboratory Demographics

CLIA Number: 36D0929856

Facility Name: FAYETTEVILLE FIRE DEPT, INC

Facility Address:
100 NORTH APPLE ST
FAYETTEVILLE, OH
ZIP 45118
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Facility Phone Number: 513 200-7908

Facility Type: Ambulance

Certificate Type: Waiver

NPI Number: 1548684210

Taxonomy: 3416L0300X - Ambulance

CLIA Record

Field Name	Field Value
CLIA Number	36D0929856
LAB Type	Ambulance
Facility Name	FAYETTEVILLE FIRE DEPT, INC
Street	100 NORTH APPLE ST
City	FAYETTEVILLE
State	OH
ZIP	45118
Phone	513 200-7908
CertificateType	4
CertificateEffectiveDate	6/25/2023
CertificateExpirationDate	6/24/2025
FacilityType	Waiver

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