36D1017615 CLIA NUMBER - RIVERSIDE EMERGENCY MEDICAL SERVICES

Laboratory Demographics

  • CLIA Code: 36D1017615
  • Facility Name: RIVERSIDE EMERGENCY MEDICAL SERVICES
  • Facility Address: 105 SOUTH BOGGS STREET P O BOX 2
    DE GRAFF, OH
    ZIP 43318
  • Facility Phone: 937 585-5819
  • Facility Type: Ambulance
  • Facility Type: Waiver
  • Lab Director: ROBERT BEATTY
  • NPI Number: 1023254323
  • Taxonomy: 251300000X - Local Education Agency (LEA)

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 36D1017615
LAB Type Ambulance
Facility Name RIVERSIDE EMERGENCY MEDICAL SERVICES
Street 105 SOUTH BOGGS STREET P O BOX 2
City DE GRAFF
State OH
ZIP 43318
Phone 937 585-5819
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/30/2025
Certificate Expiration Date 9/29/2027
Facility Type Ambulance
Lab Director ROBERT BEATTY

Download Record

Download this CLIA record record in Text format: Export

Download this CLIA record record in Excel (CSV) format: Export

Download this CLIA record record in XML format: Export

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