36D0862279 CLIA NUMBER - INTREPID USA HEALTHCARE SERVICES

Laboratory Demographics

  • CLIA Code: 36D0862279
  • Facility Name: INTREPID USA HEALTHCARE SERVICES
  • Facility Address: 1825 EAST 51ST STREET
    ASHTABULA, OH
    ZIP 44004
  • Facility Phone: 440 323-7300
  • Facility Type: Home Health Agency
  • Facility Type: Waiver
  • Lab Director: BRENDA MATNEY
  • NPI Number: 1700868346
  • Taxonomy: 251E00000X - Home Health

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CLIA Record

Field Name Field Value
CLIA Number 36D0862279
LAB Type Home Health Agency
Facility Name INTREPID USA HEALTHCARE SERVICES
Street 1825 EAST 51ST STREET
City ASHTABULA
State OH
ZIP 44004
Phone 440 323-7300
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 Home Health Agency
Lab Director BRENDA MATNEY

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