49D2250319 CLIA NUMBER - STERLING MEDICAL OCCUPATIONAL HEALTH CLINIC BLACKSTONE

Laboratory Demographics

CLIA Number: 49D2250319

Facility Name: STERLING MEDICAL OCCUPATIONAL HEALTH CLINIC BLACKSTONE

Facility Address:
700 KEMPER AVE
BLACKSTONE, VA
ZIP 23824
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Facility Phone Number: 513 984-1800

Facility Type: Practitioner Other

Certificate Type: Waiver

NPI Number: 1497927529

Taxonomy: 261QA0600X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	49D2250319
LAB Type	Practitioner Other
Facility Name	STERLING MEDICAL OCCUPATIONAL HEALTH CLINIC BLACKSTONE
Street	700 KEMPER AVE
City	BLACKSTONE
State	VA
ZIP	23824
Phone	513 984-1800
CertificateType	4
CertificateEffectiveDate	1/26/2024
CertificateExpirationDate	1/25/2026
FacilityType	Waiver

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