36D2068380 CLIA NUMBER - PORTLAND PLACE

Laboratory Demographics

  • CLIA Code: 36D2068380
  • Facility Name: PORTLAND PLACE
  • Facility Address: 3808 VENICE ROAD
    SANDUSKY, OH
    ZIP 44870
  • Facility Phone: 419 624-1090
  • Facility Type: Assisted Living Facility
  • Facility Type: Waiver
  • Lab Director: ANN BAHNSEN
  • NPI Number: 1629265939
  • Taxonomy: 310400000X - Assisted Living Facility

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CLIA Record

Field Name Field Value
CLIA Number 36D2068380
LAB Type Assisted Living Facility
Facility Name PORTLAND PLACE
Street 3808 VENICE ROAD
City SANDUSKY
State OH
ZIP 44870
Phone 419 624-1090
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 11/4/2023
Certificate Expiration Date 11/3/2025
Facility Type Assisted Living Facility
Lab Director ANN BAHNSEN

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