36D2005329 CLIA NUMBER - AUSTINTOWN MEDICAL OFFICE BUILDING

Laboratory Demographics

  • CLIA Code: 36D2005329
  • Facility Name: AUSTINTOWN MEDICAL OFFICE BUILDING
  • Facility Address: 5533 MAHONING AVENUE SECOND FLOOR
    AUSTINTOWN, OH
    ZIP 44515
  • Facility Phone: 330 793-2701
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: STEPHEN TENEYCK
  • NPI Number: 1689048233
  • Taxonomy: 310400000X - Assisted Living Facility

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CLIA Record

Field Name Field Value
CLIA Number 36D2005329
LAB Type Physician Office
Facility Name AUSTINTOWN MEDICAL OFFICE BUILDING
Street 5533 MAHONING AVENUE SECOND FLOOR
City AUSTINTOWN
State OH
ZIP 44515
Phone 330 793-2701
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/25/2024
Certificate Expiration Date 3/24/2026
Facility Type Physician Office
Lab Director STEPHEN TENEYCK

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