36D1009508 CLIA NUMBER - INDIAN LAKE EMS JOINT AMBULANCE DISTRICT

Laboratory Demographics

  • CLIA Code: 36D1009508
  • Facility Name: INDIAN LAKE EMS JOINT AMBULANCE DISTRICT
  • Facility Address: 301 NORTH OAK STREET
    LAKEVIEW, OH
    ZIP 43331
  • Facility Phone: 937 843-3000
  • Facility Type: Ambulance
  • Facility Type: Waiver
  • Lab Director: ADAM NIEDERKOHR
  • NPI Number: 1639349327
  • Taxonomy: 111N00000X - Chiropractor

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CLIA Record

Field Name Field Value
CLIA Number 36D1009508
LAB Type Ambulance
Facility Name INDIAN LAKE EMS JOINT AMBULANCE DISTRICT
Street 301 NORTH OAK STREET
City LAKEVIEW
State OH
ZIP 43331
Phone 937 843-3000
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 2/18/2025
Certificate Expiration Date 2/17/2027
Facility Type Ambulance
Lab Director ADAM NIEDERKOHR

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