36D2033336 CLIA NUMBER - ONTARIO PHYSICIAN PRACTICES

Laboratory Demographics

  • CLIA Code: 36D2033336
  • Facility Name: ONTARIO PHYSICIAN PRACTICES
  • Facility Address: 2981 W FOURTH ST
    MANSFIELD, OH
    ZIP 44906
  • Facility Phone: 419 709-8640
  • Facility Type: Rural Health Clinic
  • Facility Type: Waiver
  • Lab Director: ERIC P. HAUS
  • NPI Number: 1194154294
  • Taxonomy: 261QR1300X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 36D2033336
LAB Type Rural Health Clinic
Facility Name ONTARIO PHYSICIAN PRACTICES
Street 2981 W FOURTH ST
City MANSFIELD
State OH
ZIP 44906
Phone 419 709-8640
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 11/30/2023
Certificate Expiration Date 11/29/2025
Facility Type Rural Health Clinic
Lab Director ERIC P. HAUS

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