36D0656473 CLIA NUMBER - EDGEWOOD MANOR II OF LUCASVILLE

Laboratory Demographics

  • CLIA Code: 36D0656473
  • Facility Name: EDGEWOOD MANOR II OF LUCASVILLE
  • Facility Address: 10098A BIG BEAR CREEK ROAD
    LUCASVILLE, OH
    ZIP 45648
  • Facility Phone: 740 259-5536
  • Facility Type: Skilled Nursing Facility/Nursing Facility
  • Facility Type: Waiver
  • Lab Director: THOMAS L. BARR
  • NPI Number: 1730103813
  • Taxonomy: 314000000X - Skilled Nursing Facility

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CLIA Record

Field Name Field Value
CLIA Number 36D0656473
LAB Type Skilled Nursing Facility/Nursing Facility
Facility Name EDGEWOOD MANOR II OF LUCASVILLE
Street 10098A BIG BEAR CREEK ROAD
City LUCASVILLE
State OH
ZIP 45648
Phone 740 259-5536
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 THOMAS L. BARR

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