36D0334890 CLIA NUMBER - WICKLIFFE COUNTRY PLACE D & EXTENDED CARE

Laboratory Demographics

  • CLIA Code: 36D0334890
  • Facility Name: WICKLIFFE COUNTRY PLACE D & EXTENDED CARE
  • Facility Address: 1919 BISHOP RD
    WICKLIFFE, OH
    ZIP 44092
  • Facility Phone: 216 944-9400
  • Facility Type: Skilled Nursing Facility/Nursing Facility
  • Facility Type: Waiver
  • Lab Director: MELISSA DOMBROSKI-SCHAEFER
  • NPI Number: 1699773283
  • Taxonomy: 314000000X - Skilled Nursing Facility

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CLIA Record

Field Name Field Value
CLIA Number 36D0334890
LAB Type Skilled Nursing Facility/Nursing Facility
Facility Name WICKLIFFE COUNTRY PLACE D & EXTENDED CARE
Street 1919 BISHOP RD
City WICKLIFFE
State OH
ZIP 44092
Phone 216 944-9400
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 MELISSA DOMBROSKI-SCHAEFER

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