36D2099953 CLIA NUMBER - GREATER CANTON PSYCHIATRY, LLC

Laboratory Demographics

  • CLIA Code: 36D2099953
  • Facility Name: GREATER CANTON PSYCHIATRY, LLC
  • Facility Address: 4773 HIGBEE AVE NW
    CANTON, OH
    ZIP 44718
  • Facility Phone: 330 492-6500
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: JOHN M. VRACIU
  • NPI Number: 1528474459
  • Taxonomy: 2084P0804X - Psychiatry & Neurology

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CLIA Record

Field Name Field Value
CLIA Number 36D2099953
LAB Type Physician Office
Facility Name GREATER CANTON PSYCHIATRY, LLC
Street 4773 HIGBEE AVE NW
City CANTON
State OH
ZIP 44718
Phone 330 492-6500
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/5/2025
Certificate Expiration Date 8/4/2027
Facility Type Physician Office
Lab Director JOHN M. VRACIU

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