36D2120344 CLIA NUMBER - LICKING COUNTY JUSTICE CENTER

Home > CLIA Lookup > 36D2120344

Laboratory Demographics

CLIA Number: 36D2120344

Facility Name: LICKING COUNTY JUSTICE CENTER

Facility Address:
155 E MAIN ST
NEWARK, OH
ZIP 43055
Get Directions

Facility Phone Number: 740 670-5518

Facility Type: Other - COUNTY JAIL MEDICAL DEPT

Certificate Type: Waiver

NPI Number: 1275833428

Taxonomy: 261QA0600X - Clinic/Center

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
CertificateType	4
CertificateEffectiveDate	10/14/2022
CertificateExpirationDate	10/13/2024
FacilityType	Waiver

Download Record

Export to text format icon Download this CLIA NUMBER record in Text format: Export

Export to text format icon Download this CLIA NUMBER record in Excel (CSV) format: Export

Export to text format icon Download this CLIA NUMBER record in XML format: Export

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