36D1020339 CLIA NUMBER - AULTMAN HOSPITAL POC TESTING LABORATORY

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Laboratory Demographics

CLIA Number: 36D1020339

Facility Name: AULTMAN HOSPITAL POC TESTING LABORATORY

Facility Address:
2600 SIXTH STREET SW
CANTON, OH
ZIP 44710
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Facility Phone Number: 330 363-3378

Facility Type: Ancillary Testing Site in Health Care Center

Certificate Type: Microscopy

NPI Number: 1619911054

Taxonomy: 174400000X - Specialist
An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.

CLIA Record

Field Name	Field Value
CLIA Number	36D1020339
LAB Type	Ancillary Testing Site in Health Care Center
Facility Name	AULTMAN HOSPITAL POC TESTING LABORATORY
Street	2600 SIXTH STREET SW
City	CANTON
State	OH
ZIP	44710
Phone	330 363-3378
CertificateType	3
CertificateEffectiveDate	12/17/2023
CertificateExpirationDate	12/16/2025
FacilityType	PPMP

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