36D0724409 CLIA NUMBER - LIFECARE AMBULANCE INC

Laboratory Demographics

  • CLIA Code: 36D0724409
  • Facility Name: LIFECARE AMBULANCE INC
  • Facility Address: 640 CLEVELAND STREET
    ELYRIA, OH
    ZIP 44035
  • Facility Phone: 440 323-6111
  • Facility Type: Mobile Laboratory
  • Facility Type: Waiver
  • Lab Director: HERBERT W. DE LA PORTE
  • NPI Number: 1790742781
  • Taxonomy: 341600000X - Ambulance

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CLIA Record

Field Name Field Value
CLIA Number 36D0724409
LAB Type Mobile Laboratory
Facility Name LIFECARE AMBULANCE INC
Street 640 CLEVELAND STREET
City ELYRIA
State OH
ZIP 44035
Phone 440 323-6111
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 Mobile Laboratory
Lab Director HERBERT W. DE LA PORTE

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