36D2261425 CLIA NUMBER - JACKSON EXPRESS CARE

Laboratory Demographics

  • CLIA Code: 36D2261425
  • Facility Name: JACKSON EXPRESS CARE
  • Facility Address: 731 EAST MAIN STREET
    JACKSON, OH
    ZIP 45640
  • Facility Phone: 740 464-4445
  • Facility Type: Practitioner Other
  • Facility Type: Waiver
  • Lab Director: SAMUEL E. TOMLIN
  • NPI Number: 1043940323
  • Taxonomy: 261QU0200X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 36D2261425
LAB Type Practitioner Other
Facility Name JACKSON EXPRESS CARE
Street 731 EAST MAIN STREET
City JACKSON
State OH
ZIP 45640
Phone 740 464-4445
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 5/31/2024
Certificate Expiration Date 5/30/2026
Facility Type Practitioner Other
Lab Director SAMUEL E. TOMLIN

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This page was last updated on: 9/29/2025