36D2245718 CLIA NUMBER - MAPLEWOOD MEDICAL CARE INC

Laboratory Demographics

CLIA Number: 36D2245718

Facility Name: MAPLEWOOD MEDICAL CARE INC

Facility Address:
261 W MAIN ST
MOUNT STERLING, OH
ZIP 43143
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Facility Phone Number: 740 869-3235

Facility Type: Practitioner Other

Certificate Type: Waiver

NPI Number: 1588321764

Taxonomy: 363LF0000X - Nurse Practitioner

CLIA Record

Field Name	Field Value
CLIA Number	36D2245718
LAB Type	Practitioner Other
Facility Name	MAPLEWOOD MEDICAL CARE INC
Street	261 W MAIN ST
City	MOUNT STERLING
State	OH
ZIP	43143
Phone	740 869-3235
CertificateType	4
CertificateEffectiveDate	12/15/2023
CertificateExpirationDate	12/14/2025
FacilityType	Waiver

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