36D0930528 CLIA NUMBER - JACKSON TOWNSHIP FIRE DEPARTMENT

Laboratory Demographics

  • CLIA Code: 36D0930528
  • Facility Name: JACKSON TOWNSHIP FIRE DEPARTMENT
  • Facility Address: 7383 FULTON DRIVE NW
    MASSILLON, OH
    ZIP 44646
  • Facility Phone: 330 834-3953
  • Facility Type: Mobile Laboratory
  • Facility Type: Waiver
  • Lab Director: TIMOTHY G. BERCZIK
  • NPI Number: 1356439152
  • Taxonomy: 3416L0300X - Ambulance

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CLIA Record

Field Name Field Value
CLIA Number 36D0930528
LAB Type Mobile Laboratory
Facility Name JACKSON TOWNSHIP FIRE DEPARTMENT
Street 7383 FULTON DRIVE NW
City MASSILLON
State OH
ZIP 44646
Phone 330 834-3953
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 7/15/2025
Certificate Expiration Date 7/14/2027
Facility Type Mobile Laboratory
Lab Director TIMOTHY G. BERCZIK

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