36D1053301 CLIA NUMBER - MAUMEE VALLEY GUIDANCE CENTER

Laboratory Demographics

  • CLIA Code: 36D1053301
  • Facility Name: MAUMEE VALLEY GUIDANCE CENTER
  • Facility Address: 211 BIEDE AVENUE
    DEFIANCE, OH
    ZIP 43512
  • Facility Phone: 419 782-8856
  • Facility Type: Practitioner Other
  • Facility Type: Waiver
  • Lab Director: CONNIE PLANSON
  • NPI Number: 1639341589
  • Taxonomy: 103TP0016X - Psychologist

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CLIA Record

Field Name Field Value
CLIA Number 36D1053301
LAB Type Practitioner Other
Facility Name MAUMEE VALLEY GUIDANCE CENTER
Street 211 BIEDE AVENUE
City DEFIANCE
State OH
ZIP 43512
Phone 419 782-8856
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/20/2024
Certificate Expiration Date 4/19/2026
Facility Type Practitioner Other
Lab Director CONNIE PLANSON

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