36D2195011 CLIA NUMBER - WAYSIDE FARM INC DBA NORTHAMPTON MEADOWS (GROUP HOME)

Laboratory Demographics

  • CLIA Code: 36D2195011
  • Facility Name: WAYSIDE FARM INC DBA NORTHAMPTON MEADOWS (GROUP HOME)
  • Facility Address: 4557 QUICK ROAD
    PENINSULA, OH
    ZIP 44264
  • Facility Phone: 330 923-7828
  • Facility Type: Other - GROUP HOME
  • Facility Type: Waiver
  • Lab Director: MATTHEW W. POOL
  • NPI Number: 1306870738
  • Taxonomy: 313M00000X - Nursing Facility/Intermediate Care Facility

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CLIA Record

Field Name Field Value
CLIA Number 36D2195011
LAB Type Other - GROUP HOME
Facility Name WAYSIDE FARM INC DBA NORTHAMPTON MEADOWS (GROUP HOME)
Street 4557 QUICK ROAD
City PENINSULA
State OH
ZIP 44264
Phone 330 923-7828
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/6/2024
Certificate Expiration Date 10/5/2026
Facility Type Other - GROUP HOME
Lab Director MATTHEW W. POOL

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