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36D2129726 CLIA NUMBER - ALLERGY CLINIC, DOSC KNOX COMMUNITY HOSPITAL

Laboratory Demographics

CLIA Number: 36D2129726

Facility Name: ALLERGY CLINIC, DOSC KNOX COMMUNITY HOSPITAL

Facility Address:
10 WOODLAKE TRAIL STE B
MOUNT VERNON, OH
ZIP 43050
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Facility Phone Number: 740 393-5223

Facility Type: Physician Office

Certificate Type: Waiver
NPI Number: 1386003796

Taxonomy: 332B00000X - Durable Medical Equipment & Medical Supplies
A supplier of medical equipment such as respirators, wheelchairs, home dialysis systems, or monitoring systems, that are prescribed by a physician for a patient's use in the home and that are usable for an extended period of time.

CLIA Record

Field Name Field Value
CLIA Number 36D2129726
LAB Type Physician Office
Facility Name ALLERGY CLINIC, DOSC KNOX COMMUNITY HOSPITAL
Street 10 WOODLAKE TRAIL STE B
City MOUNT VERNON
State OH
ZIP 43050
Phone 740 393-5223
CertificateType 4
CertificateEffectiveDate 4/25/2023
CertificateExpirationDate 4/24/2025
FacilityType Waiver

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