36D2003203 CLIA NUMBER - AIR EVAC 089

Laboratory Demographics

  • CLIA Code: 36D2003203
  • Facility Name: AIR EVAC 089
  • Facility Address: 423 HOME STREET
    GEORGETOWN, OH
    ZIP 45121
  • Facility Phone: 937 378-3191
  • Facility Type: Ambulance
  • Facility Type: Waiver
  • Lab Director: STUART BALDWIN
  • NPI Number: 1194059451
  • Taxonomy: 3416A0800X - Ambulance

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CLIA Record

Field Name Field Value
CLIA Number 36D2003203
LAB Type Ambulance
Facility Name AIR EVAC 089
Street 423 HOME STREET
City GEORGETOWN
State OH
ZIP 45121
Phone 937 378-3191
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 2/3/2024
Certificate Expiration Date 2/2/2026
Facility Type Ambulance
Lab Director STUART BALDWIN

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