36D0986019 CLIA NUMBER - STILLWATER CENTER

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Field Name	Field Value
CLIA Number	36D0986019
LAB Type	Intermediate Care Facility for Mentally Retarded
Facility Name	STILLWATER CENTER
Street	8100 NORTH MAIN STREET
City	DAYTON
State	OH
ZIP	45415
Phone	937 890-0646
Certificate Type	Certificate of Waiver
Certificate Type Description	This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date	5/7/2025
Certificate Expiration Date	5/6/2027
Facility Type	Intermediate Care Facility for Mentally Retarded
Lab Director	MS. MICHELLE PIERCE-MOBLEY

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