36D2163184 CLIA NUMBER - BAYMARK HEALTH SERVICES OF OHIO, INC DBA MEDMARK TREATMENT CENTERS KENT

Laboratory Demographics

CLIA Number: 36D2163184

Facility Name: BAYMARK HEALTH SERVICES OF OHIO, INC DBA MEDMARK TREATMENT CENTERS KENT

Facility Address:
2500 STATE ROUTE 59 SUITES 28 & 30
KENT, OH
ZIP 44240
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Facility Phone Number: 502 593-5062

Facility Type: Other - NARCOTIC TREATMENT PROGRA

Certificate Type: Waiver

NPI Number: 1740815380

Taxonomy: 261QR0405X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	36D2163184
LAB Type	Other - NARCOTIC TREATMENT PROGRA
Facility Name	BAYMARK HEALTH SERVICES OF OHIO, INC DBA MEDMARK TREATMENT CENTERS KENT
Street	2500 STATE ROUTE 59 SUITES 28 & 30
City	KENT
State	OH
ZIP	44240
Phone	502 593-5062
CertificateType	4
CertificateEffectiveDate	3/8/2023
CertificateExpirationDate	3/7/2025
FacilityType	Waiver

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