36D0935611 CLIA NUMBER - PAYNE EMS

Laboratory Demographics

CLIA Number: 36D0935611

Facility Name: PAYNE EMS

Facility Address:
202 N LAURA ST
PAYNE, OH
ZIP 45880
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Facility Phone Number: 419 263-2514

Facility Type: Ambulance

Certificate Type: Waiver

NPI Number: 1235297086

Taxonomy: 3416L0300X - Ambulance

CLIA Record

Field Name	Field Value
CLIA Number	36D0935611
LAB Type	Ambulance
Facility Name	PAYNE EMS
Street	202 N LAURA ST
City	PAYNE
State	OH
ZIP	45880
Phone	419 263-2514
CertificateType	4
CertificateEffectiveDate	11/3/2023
CertificateExpirationDate	11/2/2025
FacilityType	Waiver

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