36D2155802 CLIA NUMBER - CATER-MALLETT MEDICAL SERVICES, INC

Laboratory Demographics

CLIA Number: 36D2155802

Facility Name: CATER-MALLETT MEDICAL SERVICES, INC

Facility Address:
27 EAST MAIN STREET
NEW CONCORD, OH
ZIP 43762
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Facility Phone Number: 740 584-3399

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1801378005

Taxonomy: 363LF0000X - Nurse Practitioner

CLIA Record

Field Name	Field Value
CLIA Number	36D2155802
LAB Type	Physician Office
Facility Name	CATER-MALLETT MEDICAL SERVICES, INC
Street	27 EAST MAIN STREET
City	NEW CONCORD
State	OH
ZIP	43762
Phone	740 584-3399
CertificateType	4
CertificateEffectiveDate	10/4/2022
CertificateExpirationDate	10/3/2024
FacilityType	Waiver

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