36D0968149 CLIA NUMBER - FHS BENNINGTON, INC - DBA BENNINGTON GLEN NURSING & REHABILITATION CENTER

Laboratory Demographics

  • CLIA Code: 36D0968149
  • Facility Name: FHS BENNINGTON, INC - DBA BENNINGTON GLEN NURSING & REHABILITATION CENTER
  • Facility Address: 825 STATE ROUTE 61
    MARENGO, OH
    ZIP 43334
  • Facility Phone: 419 253-0144
  • Facility Type: Skilled Nursing Facility/Nursing Facility
  • Facility Type: Waiver
  • Lab Director: CHLARK GUELOS
  • NPI Number: 1174630792
  • Taxonomy: 332BP3500X - Durable Medical Equipment & Medical Supplies

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CLIA Record

Field Name Field Value
CLIA Number 36D0968149
LAB Type Skilled Nursing Facility/Nursing Facility
Facility Name FHS BENNINGTON, INC - DBA BENNINGTON GLEN NURSING & REHABILITATION CENTER
Street 825 STATE ROUTE 61
City MARENGO
State OH
ZIP 43334
Phone 419 253-0144
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 12/3/2023
Certificate Expiration Date 12/2/2025
Facility Type Skilled Nursing Facility/Nursing Facility
Lab Director CHLARK GUELOS

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