36D0918038 CLIA NUMBER - OHIO EASTERN STAR HOME, THE

Laboratory Demographics

  • CLIA Code: 36D0918038
  • Facility Name: OHIO EASTERN STAR HOME, THE
  • Facility Address: 1451 GAMBIER RD
    MOUNT VERNON, OH
    ZIP 43050
  • Facility Phone: 740 397-1706
  • Facility Type: Skilled Nursing Facility/Nursing Facility
  • Facility Type: Waiver
  • Lab Director: TRICIA PETERSON
  • NPI Number: 1912026055
  • Taxonomy: 251E00000X - Home Health

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CLIA Record

Field Name Field Value
CLIA Number 36D0918038
LAB Type Skilled Nursing Facility/Nursing Facility
Facility Name OHIO EASTERN STAR HOME, THE
Street 1451 GAMBIER RD
City MOUNT VERNON
State OH
ZIP 43050
Phone 740 397-1706
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 7/31/2024
Certificate Expiration Date 7/30/2026
Facility Type Skilled Nursing Facility/Nursing Facility
Lab Director TRICIA PETERSON

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