36D2180783 CLIA NUMBER - EMILY PROGRAM - COLUMBUS ADULT, THE RESIDENTIAL

Laboratory Demographics

  • CLIA Code: 36D2180783
  • Facility Name: EMILY PROGRAM - COLUMBUS ADULT, THE RESIDENTIAL
  • Facility Address: 8001 RAVINES EDGE CT #201
    COLUMBUS, OH
    ZIP 43235
  • Facility Phone: 888 364-5977
  • Facility Type: Other - OUTPT FACILITY, EATING
  • Facility Type: Waiver
  • Lab Director: SARAH BERGEN
  • NPI Number: 1154696698
  • Taxonomy: 251S00000X - Community/Behavioral Health

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CLIA Record

Field Name Field Value
CLIA Number 36D2180783
LAB Type Other - OUTPT FACILITY, EATING
Facility Name EMILY PROGRAM - COLUMBUS ADULT, THE RESIDENTIAL
Street 8001 RAVINES EDGE CT #201
City COLUMBUS
State OH
ZIP 43235
Phone 888 364-5977
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 12/11/2024
Certificate Expiration Date 12/10/2026
Facility Type Other - OUTPT FACILITY, EATING
Lab Director SARAH BERGEN

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