36D2196412 CLIA NUMBER - EVERGREEN ASSISTED LIVING

Laboratory Demographics

  • CLIA Code: 36D2196412
  • Facility Name: EVERGREEN ASSISTED LIVING
  • Facility Address: 230 WEST GALBRAITH ROAD
    CINCINNATI, OH
    ZIP 45215
  • Facility Phone: 513 679-9501
  • Facility Type: Assisted Living Facility
  • Facility Type: Waiver
  • Lab Director: MERCADES M. SMITH
  • NPI Number: 1609191568
  • Taxonomy: 310400000X - Assisted Living Facility

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CLIA Record

Field Name Field Value
CLIA Number 36D2196412
LAB Type Assisted Living Facility
Facility Name EVERGREEN ASSISTED LIVING
Street 230 WEST GALBRAITH ROAD
City CINCINNATI
State OH
ZIP 45215
Phone 513 679-9501
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/16/2024
Certificate Expiration Date 10/15/2026
Facility Type Assisted Living Facility
Lab Director MERCADES M. SMITH

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