36D2082059 CLIA NUMBER - NATIONAL CHURCH RESIDENCES LEGACY VILLAGE

Laboratory Demographics

  • CLIA Code: 36D2082059
  • Facility Name: NATIONAL CHURCH RESIDENCES LEGACY VILLAGE
  • Facility Address: 695 WYCLIFF DR ATTN EXECUTIVE DIRECTOR
    XENIA, OH
    ZIP 45385
  • Facility Phone: 937 372-0359
  • Facility Type: Assisted Living Facility
  • Facility Type: Waiver
  • Lab Director: STEVEN E. THROOP
  • NPI Number: 1578868386
  • Taxonomy: 310400000X - Assisted Living Facility

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CLIA Record

Field Name Field Value
CLIA Number 36D2082059
LAB Type Assisted Living Facility
Facility Name NATIONAL CHURCH RESIDENCES LEGACY VILLAGE
Street 695 WYCLIFF DR ATTN EXECUTIVE DIRECTOR
City XENIA
State OH
ZIP 45385
Phone 937 372-0359
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/6/2024
Certificate Expiration Date 8/5/2026
Facility Type Assisted Living Facility
Lab Director STEVEN E. THROOP

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