36D2228281 CLIA NUMBER - KNOX RECOVERY

Laboratory Demographics

CLIA Number: 36D2228281

Facility Name: KNOX RECOVERY

Facility Address:
113 W GAMBIER ST
MOUNT VERNON, OH
ZIP 43050
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Facility Phone Number: 740 326-9099

Facility Type: Other - DRUG & ALCOHOL REHAB CTR

Certificate Type: Waiver

NPI Number: 1245902576

Taxonomy: 101YA0400X - Counselor

CLIA Record

Field Name	Field Value
CLIA Number	36D2228281
LAB Type	Other - DRUG & ALCOHOL REHAB CTR
Facility Name	KNOX RECOVERY
Street	113 W GAMBIER ST
City	MOUNT VERNON
State	OH
ZIP	43050
Phone	740 326-9099
CertificateType	4
CertificateEffectiveDate	6/24/2023
CertificateExpirationDate	6/23/2025
FacilityType	Waiver

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