36D0333663 CLIA NUMBER - ASHTABULA CTY COMMUNITY ACTION AGENCY

Laboratory Demographics

  • CLIA Code: 36D0333663
  • Facility Name: ASHTABULA CTY COMMUNITY ACTION AGENCY
  • Facility Address: 4200 STATE ROAD
    ASHTABULA, OH
    ZIP 44004
  • Facility Phone: 216 998-7515
  • Facility Type: Community Clinic
  • Facility Type: Waiver
  • Lab Director: DIANA R. BROOK
  • NPI Number: 1790717205
  • Taxonomy: 261QA1903X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 36D0333663
LAB Type Community Clinic
Facility Name ASHTABULA CTY COMMUNITY ACTION AGENCY
Street 4200 STATE ROAD
City ASHTABULA
State OH
ZIP 44004
Phone 216 998-7515
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 Community Clinic
Lab Director DIANA R. BROOK

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