36D2166669 CLIA NUMBER - PORTAGE PATH BEHAVIORAL HEALTH

Laboratory Demographics

  • CLIA Code: 36D2166669
  • Facility Name: PORTAGE PATH BEHAVIORAL HEALTH
  • Facility Address: 105 FIFTH ST SE SUITE 6
    BARBERTON, OH
    ZIP 44203
  • Facility Phone: 330 253-3100
  • Facility Type: Practitioner Other
  • Facility Type: Waiver
  • Lab Director: RAMAN KRIMPURI
  • NPI Number: 1114492147
  • Taxonomy: 261QR0405X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 36D2166669
LAB Type Practitioner Other
Facility Name PORTAGE PATH BEHAVIORAL HEALTH
Street 105 FIFTH ST SE SUITE 6
City BARBERTON
State OH
ZIP 44203
Phone 330 253-3100
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 5/22/2025
Certificate Expiration Date 5/21/2027
Facility Type Practitioner Other
Lab Director RAMAN KRIMPURI

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