36D2276819 CLIA NUMBER - FRESH MARK HEALTH CENTER

Laboratory Demographics

  • CLIA Code: 36D2276819
  • Facility Name: FRESH MARK HEALTH CENTER
  • Facility Address: 1775 SOUTH LINCOLN AVE SUITE #1
    SALEM, OH
    ZIP 44460
  • Facility Phone: 802 857-0400
  • Facility Type: Other - ONSITE HEALTH CENTER
  • Facility Type: Waiver
  • Lab Director: GINA KELLEY
  • NPI Number: 1144945593
  • Taxonomy: 363LF0000X - Nurse Practitioner

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CLIA Record

Field Name Field Value
CLIA Number 36D2276819
LAB Type Other - ONSITE HEALTH CENTER
Facility Name FRESH MARK HEALTH CENTER
Street 1775 SOUTH LINCOLN AVE SUITE #1
City SALEM
State OH
ZIP 44460
Phone 802 857-0400
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 2/15/2025
Certificate Expiration Date 2/14/2027
Facility Type Other - ONSITE HEALTH CENTER
Lab Director GINA KELLEY

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