36D0988859 CLIA NUMBER - CARROLL FAMILY HEALTHCARE

Laboratory Demographics

CLIA Number: 36D0988859

Facility Name: CARROLL FAMILY HEALTHCARE

Facility Address:
635 LOCUST STREET
MALVERN, OH
ZIP 44644
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Facility Phone Number: 330 863-9061

Facility Type: Physician Office

Certificate Type: Microscopy

NPI Number: 1235221169

Taxonomy: 261QP2300X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	36D0988859
LAB Type	Physician Office
Facility Name	CARROLL FAMILY HEALTHCARE
Street	635 LOCUST STREET
City	MALVERN
State	OH
ZIP	44644
Phone	330 863-9061
CertificateType	3
CertificateEffectiveDate	7/10/2023
CertificateExpirationDate	7/9/2025
FacilityType	PPMP

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