36D0993071 CLIA NUMBER - PEMBERVILLE FREEDOM FIRE DEPT

Laboratory Demographics

  • CLIA Code: 36D0993071
  • Facility Name: PEMBERVILLE FREEDOM FIRE DEPT
  • Facility Address: 104 EAST FRONT STREET
    PEMBERVILLE, OH
    ZIP 43450
  • Facility Phone: 419 287-4593
  • Facility Type: Ambulance
  • Facility Type: Waiver
  • Lab Director: THOMAS BOGGS
  • NPI Number: 1184907115
  • Taxonomy: 3336L0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 36D0993071
LAB Type Ambulance
Facility Name PEMBERVILLE FREEDOM FIRE DEPT
Street 104 EAST FRONT STREET
City PEMBERVILLE
State OH
ZIP 43450
Phone 419 287-4593
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 11/5/2023
Certificate Expiration Date 11/4/2025
Facility Type Ambulance
Lab Director THOMAS BOGGS

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