36D0896956 CLIA NUMBER - SAMUEL HOUSE

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Field Name	Field Value
CLIA Number	36D0896956
LAB Type	Intermediate Care Facility for Mentally Retarded
Facility Name	SAMUEL HOUSE
Street	2088 SAMUEL ROAD
City	BRUNSWICK
State	OH
ZIP	44212
Phone	330 220-7397
Certificate Type	Certificate of Waiver
Certificate Type Description	This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date	1/25/2025
Certificate Expiration Date	1/24/2027
Facility Type	Intermediate Care Facility for Mentally Retarded
Lab Director	DENISE T. POZERAC

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