36D0901045 CLIA NUMBER - GALLIPOLIS DEVELOPMENTAL CENTER

Laboratory Demographics

  • CLIA Code: 36D0901045
  • Facility Name: GALLIPOLIS DEVELOPMENTAL CENTER
  • Facility Address: 2500 OHIO AVENUE
    GALLIPOLIS, OH
    ZIP 45631
  • Facility Phone: (614) 446-1642
  • Facility Type: Intermediate Care Facility for Mentally Retarded
  • Facility Type: Waiver
  • Lab Director: CHRISTINA KREMER-GOODSON
  • NPI Number: 1881082006
  • Taxonomy: 314000000X - Skilled Nursing Facility

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CLIA Record

Field Name Field Value
CLIA Number 36D0901045
LAB Type Intermediate Care Facility for Mentally Retarded
Facility Name GALLIPOLIS DEVELOPMENTAL CENTER
Street 2500 OHIO AVENUE
City GALLIPOLIS
State OH
ZIP 45631
Phone 6144461642
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 5/15/2025
Certificate Expiration Date 5/14/2027
Facility Type Intermediate Care Facility for Mentally Retarded
Lab Director CHRISTINA KREMER-GOODSON

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This page was last updated on: 5/18/2026