36D0718118 CLIA NUMBER - OTTERBEIN ST MARYS

Laboratory Demographics

  • CLIA Code: 36D0718118
  • Facility Name: OTTERBEIN ST MARYS
  • Facility Address: 11230 CIRCLE DR STATE ROUTE 364
    ST MARYS, OH
    ZIP 45885
  • Facility Phone: 419 394-1622
  • Facility Type: Skilled Nursing Facility/Nursing Facility
  • Facility Type: Waiver
  • Lab Director: NEAL HOLLERAN
  • NPI Number: 1154984565
  • Taxonomy: 310400000X - Assisted Living Facility

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CLIA Record

Field Name Field Value
CLIA Number 36D0718118
LAB Type Skilled Nursing Facility/Nursing Facility
Facility Name OTTERBEIN ST MARYS
Street 11230 CIRCLE DR STATE ROUTE 364
City ST MARYS
State OH
ZIP 45885
Phone 419 394-1622
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 NEAL HOLLERAN

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