36D1011921 CLIA NUMBER - MACOCHEE JOINT AMBULANCE DISTRICT

Laboratory Demographics

  • CLIA Code: 36D1011921
  • Facility Name: MACOCHEE JOINT AMBULANCE DISTRICT
  • Facility Address: 113 E NEWELL STREET
    WEST LIBERTY, OH
    ZIP 43357
  • Facility Phone: 937 465-7170
  • Facility Type: Federally Qualified Health Center
  • Facility Type: Waiver
  • Lab Director: CHRIS JONES
  • NPI Number: 1598042707
  • Taxonomy: 3416L0300X - Ambulance

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CLIA Record

Field Name Field Value
CLIA Number 36D1011921
LAB Type Federally Qualified Health Center
Facility Name MACOCHEE JOINT AMBULANCE DISTRICT
Street 113 E NEWELL STREET
City WEST LIBERTY
State OH
ZIP 43357
Phone 937 465-7170
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/28/2025
Certificate Expiration Date 4/27/2027
Facility Type Federally Qualified Health Center
Lab Director CHRIS JONES

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