36D0344521 CLIA NUMBER - MANSFIELD MEMORIAL HOMES

Laboratory Demographics

  • CLIA Code: 36D0344521
  • Facility Name: MANSFIELD MEMORIAL HOMES
  • Facility Address: 50 BLYMYER AVENUE
    MANSFIELD, OH
    ZIP 44903
  • Facility Phone: 419 524-4178
  • Facility Type: Skilled Nursing Facility/Nursing Facility
  • Facility Type: Waiver
  • Lab Director: PRADYUMNA PADIVAL MD
  • NPI Number: 1104823889
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 36D0344521
LAB Type Skilled Nursing Facility/Nursing Facility
Facility Name MANSFIELD MEMORIAL HOMES
Street 50 BLYMYER AVENUE
City MANSFIELD
State OH
ZIP 44903
Phone 419 524-4178
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 PRADYUMNA PADIVAL MD

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