36D1042965 CLIA NUMBER - CORNELL ABRAXAS OF OHIO CORNELL CORRECTIONS INC

Laboratory Demographics

  • CLIA Code: 36D1042965
  • Facility Name: CORNELL ABRAXAS OF OHIO CORNELL CORRECTIONS INC
  • Facility Address: 2775 STATE ROUTE 39
    SHELBY, OH
    ZIP 44875
  • Facility Phone: 419 747-3322
  • Facility Type: Other
  • Facility Type: Waiver
  • Lab Director: BRUCE TESSENA
  • NPI Number: 1134385669
  • Taxonomy: 3245S0500X - Substance Abuse Rehabilitation Facility

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CLIA Record

Field Name Field Value
CLIA Number 36D1042965
LAB Type Other
Facility Name CORNELL ABRAXAS OF OHIO CORNELL CORRECTIONS INC
Street 2775 STATE ROUTE 39
City SHELBY
State OH
ZIP 44875
Phone 419 747-3322
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 7/13/2025
Certificate Expiration Date 7/12/2027
Facility Type Other
Lab Director BRUCE TESSENA

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