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36D1042748 CLIA NUMBER - NORTHWOOD DIALYSIS

Laboratory Demographics

CLIA Number: 36D1042748

Facility Name: NORTHWOOD DIALYSIS

Facility Address:
611 LEMOYNE ROAD
NORTHWOOD, OH
ZIP 43619
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Facility Phone Number: 419 698-3423

Facility Type: End Stage Renal Disease Dialysis Facility

Certificate Type: Waiver
NPI Number: 1639310071

Taxonomy: 251300000X - Local Education Agency (LEA)
The term local education agency means a public board of education or other public authority legally constituted within a State to either provide administrative control or direction of, or perform a service function for public schools serving individuals ages 0 - 21 in a state, city, county, township, school district, or other political subdivision including a combination of school districts or counties recognized in a State as an administrative agency for its public schools. An LEA may provide, or employ professional who provide, services to children included in the Individuals with Disabilities Education Act (IDEA), such services may include, but are not limited to, such medical services as physical, occupational, and speech therapy.

CLIA Record

Field Name Field Value
CLIA Number 36D1042748
LAB Type End Stage Renal Disease Dialysis Facility
Facility Name NORTHWOOD DIALYSIS
Street 611 LEMOYNE ROAD
City NORTHWOOD
State OH
ZIP 43619
Phone 419 698-3423
CertificateType 4
CertificateEffectiveDate 7/7/2023
CertificateExpirationDate 7/6/2025
FacilityType Waiver

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