36D2177275 CLIA NUMBER - NABHCO

Laboratory Demographics

CLIA Number: 36D2177275

Facility Name: NABHCO

Facility Address:
2686 CROSSROADS PLAZA DRIVE
COLUMBUS, OH
ZIP 43219
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Facility Phone Number: 877 318-0934

Facility Type: Practitioner Other

Certificate Type: Waiver

NPI Number: 1952940835

Taxonomy: 207QA0401X - Family Medicine
A family medicine physician who specializes in the diagnosis and treatment of addictions.

CLIA Record

Field Name	Field Value
CLIA Number	36D2177275
LAB Type	Practitioner Other
Facility Name	NABHCO
Street	2686 CROSSROADS PLAZA DRIVE
City	COLUMBUS
State	OH
ZIP	43219
Phone	877 318-0934
CertificateType	4
CertificateEffectiveDate	1/8/2024
CertificateExpirationDate	1/7/2026
FacilityType	Waiver

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