36D0331140 CLIA NUMBER - FAIRLAWN HAVEN

Laboratory Demographics

  • CLIA Code: 36D0331140
  • Facility Name: FAIRLAWN HAVEN
  • Facility Address: 407 E LUTZ RD
    ARCHBOLD, OH
    ZIP 43502
  • Facility Phone: 419 445-3075
  • Facility Type: Skilled Nursing Facility/Nursing Facility
  • Facility Type: Waiver
  • Lab Director: REBECCA HATTON
  • NPI Number: 1003813148
  • Taxonomy: 314000000X - Skilled Nursing Facility

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CLIA Record

Field Name Field Value
CLIA Number 36D0331140
LAB Type Skilled Nursing Facility/Nursing Facility
Facility Name FAIRLAWN HAVEN
Street 407 E LUTZ RD
City ARCHBOLD
State OH
ZIP 43502
Phone 419 445-3075
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/1/2024
Certificate Expiration Date 8/31/2026
Facility Type Skilled Nursing Facility/Nursing Facility
Lab Director REBECCA HATTON

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