36D2142418 CLIA NUMBER - OHIOHEALTH DELAWARE DERMATOLOGY

Laboratory Demographics

CLIA Number: 36D2142418

Facility Name: OHIOHEALTH DELAWARE DERMATOLOGY

Facility Address:
801 OHIOHEALTH BLVD, SUITE 230
DELAWARE, OH
ZIP 43015
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Facility Phone Number: 614 788-8410

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1700034469

Taxonomy: 261QS1200X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	36D2142418
LAB Type	Physician Office
Facility Name	OHIOHEALTH DELAWARE DERMATOLOGY
Street	801 OHIOHEALTH BLVD, SUITE 230
City	DELAWARE
State	OH
ZIP	43015
Phone	614 788-8410
CertificateType	4
CertificateEffectiveDate	1/10/2024
CertificateExpirationDate	1/9/2026
FacilityType	Waiver

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