36D0655891 CLIA NUMBER - ASTORIA PLACE OF WATERVILLE

Laboratory Demographics

  • CLIA Code: 36D0655891
  • Facility Name: ASTORIA PLACE OF WATERVILLE
  • Facility Address: 555 ANTHONY WAYNE TRAIL
    WATERVILLE, OH
    ZIP 43566
  • Facility Phone: 419 878-3901
  • Facility Type: Skilled Nursing Facility/Nursing Facility
  • Facility Type: Waiver
  • Lab Director: SETH A. ROBERTS
  • NPI Number: 1972980100
  • Taxonomy: 314000000X - Skilled Nursing Facility

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CLIA Record

Field Name Field Value
CLIA Number 36D0655891
LAB Type Skilled Nursing Facility/Nursing Facility
Facility Name ASTORIA PLACE OF WATERVILLE
Street 555 ANTHONY WAYNE TRAIL
City WATERVILLE
State OH
ZIP 43566
Phone 419 878-3901
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 SETH A. ROBERTS

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