36D0946911 CLIA NUMBER - EMBASSY LONGMEADOW LLC

Laboratory Demographics

  • CLIA Code: 36D0946911
  • Facility Name: EMBASSY LONGMEADOW LLC
  • Facility Address: 565 BRYN MAWR STREET
    RAVENNA, OH
    ZIP 44266
  • Facility Phone: (330) 297-5781
  • Facility Type: Skilled Nursing Facility/Nursing Facility
  • Facility Type: Waiver
  • Lab Director: GREGG BUCKNER
  • NPI Number: 1912374083
  • Taxonomy: 314000000X - Skilled Nursing Facility

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CLIA Record

Field Name Field Value
CLIA Number 36D0946911
LAB Type Skilled Nursing Facility/Nursing Facility
Facility Name EMBASSY LONGMEADOW LLC
Street 565 BRYN MAWR STREET
City RAVENNA
State OH
ZIP 44266
Phone 3302975781
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 6/4/2026
Certificate Expiration Date 6/3/2028
Facility Type Skilled Nursing Facility/Nursing Facility
Lab Director GREGG BUCKNER

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