36D2120344 CLIA NUMBER - LICKING COUNTY JUSTICE CENTER

Laboratory Demographics

  • CLIA Code: 36D2120344
  • Facility Name: LICKING COUNTY JUSTICE CENTER
  • Facility Address: 155 E MAIN ST
    NEWARK, OH
    ZIP 43055
  • Facility Phone: 740 670-5518
  • Facility Type: Other - COUNTY JAIL MEDICAL DEPT
  • Facility Type: Waiver
  • Lab Director: MICHAEL E. CAMPOLO
  • NPI Number: 1275833428
  • Taxonomy: 261QA0600X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 36D2120344
LAB Type Other - COUNTY JAIL MEDICAL DEPT
Facility Name LICKING COUNTY JUSTICE CENTER
Street 155 E MAIN ST
City NEWARK
State OH
ZIP 43055
Phone 740 670-5518
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/14/2024
Certificate Expiration Date 10/13/2026
Facility Type Other - COUNTY JAIL MEDICAL DEPT
Lab Director MICHAEL E. CAMPOLO

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