36D1099306 CLIA NUMBER - BROOKESIDE AMBULANCE SERVICE INC

Laboratory Demographics

  • CLIA Code: 36D1099306
  • Facility Name: BROOKESIDE AMBULANCE SERVICE INC
  • Facility Address: 640 PHILLIPS AVENUE
    TOLEDO, OH
    ZIP 43612
  • Facility Phone: 419 476-7442
  • Facility Type: Ambulance
  • Facility Type: Waiver
  • Lab Director: DONALD J. KISH
  • NPI Number: 1497822100
  • Taxonomy: 343900000X - Non-emergency Medical Transport (VAN)

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CLIA Record

Field Name Field Value
CLIA Number 36D1099306
LAB Type Ambulance
Facility Name BROOKESIDE AMBULANCE SERVICE INC
Street 640 PHILLIPS AVENUE
City TOLEDO
State OH
ZIP 43612
Phone 419 476-7442
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 5/11/2025
Certificate Expiration Date 5/10/2027
Facility Type Ambulance
Lab Director DONALD J. KISH

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