36D2297252 CLIA NUMBER - RIVER VALLEY PHYSICIANS INTERNAL MEDICINE 2

Laboratory Demographics

CLIA Number: 36D2297252

Facility Name: RIVER VALLEY PHYSICIANS INTERNAL MEDICINE 2

Facility Address:
130 WEST FOURTH STREET
EAST LIVERPOOL, OH
ZIP 43920
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Facility Phone Number: 330 385-7977

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1720166044

Taxonomy: 247100000X - Radiologic Technologist
A medical imaging or radiation therapy professional who is appropriately educated and trained to perform medical imaging procedures using ionizing and nonionizing radiation.

CLIA Record

Field Name	Field Value
CLIA Number	36D2297252
LAB Type	Physician Office
Facility Name	RIVER VALLEY PHYSICIANS INTERNAL MEDICINE 2
Street	130 WEST FOURTH STREET
City	EAST LIVERPOOL
State	OH
ZIP	43920
Phone	330 385-7977
CertificateType	4
CertificateEffectiveDate	1/12/2024
CertificateExpirationDate	1/11/2026
FacilityType	Waiver

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