36D1095620 CLIA NUMBER - REHABILITATION CARE GROUP - COLUMBUS

Laboratory Demographics

CLIA Number: 36D1095620

Facility Name: REHABILITATION CARE GROUP - COLUMBUS

Facility Address:
2599 TILLER LN STE A
COLUMBUS, OH
ZIP 43231
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Facility Phone Number: 614 880-5348

Facility Type: Other - ADDICTION MEDICINE CLINIC

Certificate Type: Waiver

NPI Number: 1689033532

Taxonomy: 101YA0400X - Counselor

CLIA Record

Field Name	Field Value
CLIA Number	36D1095620
LAB Type	Other - ADDICTION MEDICINE CLINIC
Facility Name	REHABILITATION CARE GROUP - COLUMBUS
Street	2599 TILLER LN STE A
City	COLUMBUS
State	OH
ZIP	43231
Phone	614 880-5348
CertificateType	4
CertificateEffectiveDate	2/12/2023
CertificateExpirationDate	2/11/2025
FacilityType	Waiver

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