36D2085149 CLIA NUMBER - MOUNT CARMEL GROVE CITY CARDIAC PULMONARY REHAB

Laboratory Demographics

  • CLIA Code: 36D2085149
  • Facility Name: MOUNT CARMEL GROVE CITY CARDIAC PULMONARY REHAB
  • Facility Address: 5350 N MEADOW DR STE 220
    GROVE CITY, OH
    ZIP 43123
  • Facility Phone: 614 663-4001
  • Facility Type: Other - OUTPATIENT CARDIAC REHAB
  • Facility Type: Waiver
  • Lab Director: JASON EVANCHAN
  • NPI Number: 1578738357
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 36D2085149
LAB Type Other - OUTPATIENT CARDIAC REHAB
Facility Name MOUNT CARMEL GROVE CITY CARDIAC PULMONARY REHAB
Street 5350 N MEADOW DR STE 220
City GROVE CITY
State OH
ZIP 43123
Phone 614 663-4001
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/8/2024
Certificate Expiration Date 10/7/2026
Facility Type Other - OUTPATIENT CARDIAC REHAB
Lab Director JASON EVANCHAN

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