36D2112164 CLIA NUMBER - MERCY HEALTH ADA FAMILY MEDICINE

Laboratory Demographics

CLIA Number: 36D2112164

Facility Name: MERCY HEALTH ADA FAMILY MEDICINE

Facility Address:
604 W NORTH AVE
ADA, OH
ZIP 45810
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Facility Phone Number: 419 634-0431

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1275764607

Taxonomy: 282N00000X - General Acute Care Hospital
An acute general hospital is an institution whose primary function is to provide inpatient diagnostic and therapeutic services for a variety of medical conditions, both surgical and non-surgical, to a wide population group. The hospital treats patients in an acute phase of illness or injury, characterized by a single episode or a fairly short duration, from which the patient returns to his or her normal or previous level of activity.

CLIA Record

Field Name	Field Value
CLIA Number	36D2112164
LAB Type	Physician Office
Facility Name	MERCY HEALTH ADA FAMILY MEDICINE
Street	604 W NORTH AVE
City	ADA
State	OH
ZIP	45810
Phone	419 634-0431
CertificateType	4
CertificateEffectiveDate	4/25/2024
CertificateExpirationDate	4/24/2026
FacilityType	Waiver

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This page was last updated on: 4/23/2024