36D2062382 CLIA NUMBER - KINGSBURY HOUSE

Laboratory Demographics

  • CLIA Code: 36D2062382
  • Facility Name: KINGSBURY HOUSE
  • Facility Address: 245 W ROSEWOOD AVENUE
    DEFIANCE, OH
    ZIP 43512
  • Facility Phone: 419 782-6324
  • Facility Type: Assisted Living Facility
  • Facility Type: Waiver
  • Lab Director: SABRENA FIELDS
  • NPI Number: 1477740785
  • Taxonomy: 310400000X - Assisted Living Facility

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 36D2062382
LAB Type Assisted Living Facility
Facility Name KINGSBURY HOUSE
Street 245 W ROSEWOOD AVENUE
City DEFIANCE
State OH
ZIP 43512
Phone 419 782-6324
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 7/16/2025
Certificate Expiration Date 7/15/2027
Facility Type Assisted Living Facility
Lab Director SABRENA FIELDS

Download Record

Download this CLIA record record in Text format: Export

Download this CLIA record record in Excel (CSV) format: Export

Download this CLIA record record in XML format: Export

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