36D0719999 CLIA NUMBER - BREWSTER CONVALESCENT CENTER

Laboratory Demographics

  • CLIA Code: 36D0719999
  • Facility Name: BREWSTER CONVALESCENT CENTER
  • Facility Address: 264 MOHICAN STREET
    BREWSTER, OH
    ZIP 44613
  • Facility Phone: 216 832-2171
  • Facility Type: Skilled Nursing Facility/Nursing Facility
  • Facility Type: Waiver
  • Lab Director: CATHY C. RADERCHAK
  • NPI Number: 1083717102
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 36D0719999
LAB Type Skilled Nursing Facility/Nursing Facility
Facility Name BREWSTER CONVALESCENT CENTER
Street 264 MOHICAN STREET
City BREWSTER
State OH
ZIP 44613
Phone 216 832-2171
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 CATHY C. RADERCHAK

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