36D0655738 CLIA NUMBER - MOUNT VERNON DEVELOPMENTAL CENTER

Laboratory Demographics

  • CLIA Code: 36D0655738
  • Facility Name: MOUNT VERNON DEVELOPMENTAL CENTER
  • Facility Address: 1250 VERNONVIEW DRIVE
    MOUNT VERNON, OH
    ZIP 43050
  • Facility Phone: 740 393-6360
  • Facility Type: Intermediate Care Facility for Mentally Retarded
  • Facility Type: Waiver
  • Lab Director: MIRELA CRISAN
  • NPI Number: 1205936101
  • Taxonomy: 208600000X - Surgery

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CLIA Record

Field Name Field Value
CLIA Number 36D0655738
LAB Type Intermediate Care Facility for Mentally Retarded
Facility Name MOUNT VERNON DEVELOPMENTAL CENTER
Street 1250 VERNONVIEW DRIVE
City MOUNT VERNON
State OH
ZIP 43050
Phone 740 393-6360
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 11/19/2023
Certificate Expiration Date 11/18/2025
Facility Type Intermediate Care Facility for Mentally Retarded
Lab Director MIRELA CRISAN

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