44D1087816 CLIA NUMBER - AIR EVAC 75 AIR EVAC EMS, INC

Laboratory Demographics

CLIA Number: 44D1087816

Facility Name: AIR EVAC 75 AIR EVAC EMS, INC

Facility Address:
435 WILKINSON DR
DYERSBURG, TN
ZIP 38024
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Facility Phone Number: 731 285-1402

Facility Type: Ambulance

Certificate Type: Waiver

NPI Number: 1871775221

Taxonomy: 3416A0800X - Ambulance

CLIA Record

Field Name	Field Value
CLIA Number	44D1087816
LAB Type	Ambulance
Facility Name	AIR EVAC 75 AIR EVAC EMS, INC
Street	435 WILKINSON DR
City	DYERSBURG
State	TN
ZIP	38024
Phone	731 285-1402
CertificateType	4
CertificateEffectiveDate	8/12/2022
CertificateExpirationDate	8/11/2024
FacilityType	Waiver

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