36D1072428 CLIA NUMBER - AVALON BY OTTERBEIN PERRYSBURG

Laboratory Demographics

  • CLIA Code: 36D1072428
  • Facility Name: AVALON BY OTTERBEIN PERRYSBURG
  • Facility Address: 3529 RIVERS EDGE DRIVE
    PERRYSBURG, OH
    ZIP 43551
  • Facility Phone: 419 872-8443
  • Facility Type: Skilled Nursing Facility/Nursing Facility
  • Facility Type: Waiver
  • Lab Director: LISA M. HART
  • NPI Number: 1003939786
  • Taxonomy: 314000000X - Skilled Nursing Facility

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CLIA Record

Field Name Field Value
CLIA Number 36D1072428
LAB Type Skilled Nursing Facility/Nursing Facility
Facility Name AVALON BY OTTERBEIN PERRYSBURG
Street 3529 RIVERS EDGE DRIVE
City PERRYSBURG
State OH
ZIP 43551
Phone 419 872-8443
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/16/2025
Certificate Expiration Date 8/15/2027
Facility Type Skilled Nursing Facility/Nursing Facility
Lab Director LISA M. HART

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