36D0873340 CLIA NUMBER - MANSFIELD CORRECTIONAL INSTITUTION LAB

Laboratory Demographics

CLIA Number: 36D0873340

Facility Name: MANSFIELD CORRECTIONAL INSTITUTION LAB

Facility Address:
1150 N MAIN STREET
MANSFIELD, OH
ZIP 44903
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Facility Phone Number: 419 526-2000

Facility Type: Prison

Certificate Type: Waiver

NPI Number: 1063409738

Taxonomy: 315P00000X - Intermediate Care Facility, Intellectual Disabilities
An intermediate care facility providing services for individuals with intellectual disabilities.

CLIA Record

Field Name	Field Value
CLIA Number	36D0873340
LAB Type	Prison
Facility Name	MANSFIELD CORRECTIONAL INSTITUTION LAB
Street	1150 N MAIN STREET
City	MANSFIELD
State	OH
ZIP	44903
Phone	419 526-2000
CertificateType	4
CertificateEffectiveDate	3/9/2024
CertificateExpirationDate	3/8/2026
FacilityType	Waiver

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This page was last updated on: 4/23/2024