36D2230278 CLIA NUMBER - LIVING HOPE PRIMARY HEALTH CARE, LLC

Laboratory Demographics

CLIA Number: 36D2230278

Facility Name: LIVING HOPE PRIMARY HEALTH CARE, LLC

Facility Address:
270 SOUTH GRANT AVENUE
COLUMBUS, OH
ZIP 43215
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Facility Phone Number: 614 869-1014

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1679179980

Taxonomy: 261Q00000X - Clinic/Center
A facility or distinct part of one used for the diagnosis and treatment of outpatients. Clinic/Center is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health).

CLIA Record

Field Name	Field Value
CLIA Number	36D2230278
LAB Type	Physician Office
Facility Name	LIVING HOPE PRIMARY HEALTH CARE, LLC
Street	270 SOUTH GRANT AVENUE
City	COLUMBUS
State	OH
ZIP	43215
Phone	614 869-1014
CertificateType	4
CertificateEffectiveDate	7/21/2023
CertificateExpirationDate	7/20/2025
FacilityType	Waiver

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