36D0963111 CLIA NUMBER - INTERIM HEALTHCARE OF COSHOCTON

Laboratory Demographics

CLIA Number: 36D0963111

Facility Name: INTERIM HEALTHCARE OF COSHOCTON

Facility Address:
420 DOWNTOWNER PLAZA
COSHOCTON, OH
ZIP 43812
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Facility Phone Number: 740 623-2949

Facility Type: Home Health Agency

Certificate Type: Waiver

NPI Number: 1609355189

Taxonomy: 251G00000X - Hospice Care, Community Based

CLIA Record

Field Name	Field Value
CLIA Number	36D0963111
LAB Type	Home Health Agency
Facility Name	INTERIM HEALTHCARE OF COSHOCTON
Street	420 DOWNTOWNER PLAZA
City	COSHOCTON
State	OH
ZIP	43812
Phone	740 623-2949
CertificateType	4
CertificateEffectiveDate	7/23/2023
CertificateExpirationDate	7/22/2025
FacilityType	Waiver

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