36D1034155 CLIA NUMBER - ORRVILLA MAPLE TERRACE

Laboratory Demographics

CLIA Number: 36D1034155

Facility Name: ORRVILLA MAPLE TERRACE

Facility Address:
333 EAST SASSAFRAS STREET
ORRVILLE, OH
ZIP 44667
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Facility Phone Number: 330 683-4455

Facility Type: Other

Certificate Type: Waiver

NPI Number: 1588032965

Taxonomy: 310400000X - Assisted Living Facility
A facility providing supportive services to individuals who can function independently in most areas of activity, but need assistance and/or monitoring to assure safety and well being.

CLIA Record

Field Name	Field Value
CLIA Number	36D1034155
LAB Type	Other
Facility Name	ORRVILLA MAPLE TERRACE
Street	333 EAST SASSAFRAS STREET
City	ORRVILLE
State	OH
ZIP	44667
Phone	330 683-4455
CertificateType	4
CertificateEffectiveDate	11/29/2022
CertificateExpirationDate	11/28/2024
FacilityType	Waiver

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This page was last updated on: 4/23/2024