36D2135444 CLIA NUMBER - ALL SEASONS MEDICAL CLINIC, INC

Laboratory Demographics

CLIA Number: 36D2135444

Facility Name: ALL SEASONS MEDICAL CLINIC, INC

Facility Address:
699 HARRISBURG PIKE, STE A & B
COLUMBUS, OH
ZIP 43223
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Facility Phone Number: 614 274-2077

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1639695778

Taxonomy: 261QP2300X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	36D2135444
LAB Type	Physician Office
Facility Name	ALL SEASONS MEDICAL CLINIC, INC
Street	699 HARRISBURG PIKE, STE A & B
City	COLUMBUS
State	OH
ZIP	43223
Phone	614 274-2077
CertificateType	4
CertificateEffectiveDate	8/22/2023
CertificateExpirationDate	8/21/2025
FacilityType	Waiver

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