36D2199411 CLIA NUMBER - RITENOUR MEDICAL

Laboratory Demographics

  • CLIA Code: 36D2199411
  • Facility Name: RITENOUR MEDICAL
  • Facility Address: 380 CLINE AVE SUITE 1
    MANSFIELD, OH
    ZIP 44907
  • Facility Phone: 419 571-5290
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: PAUL E. RITENOUR
  • NPI Number: 1780226092
  • Taxonomy: 261QP2300X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 36D2199411
LAB Type Physician Office
Facility Name RITENOUR MEDICAL
Street 380 CLINE AVE SUITE 1
City MANSFIELD
State OH
ZIP 44907
Phone 419 571-5290
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 11/9/2024
Certificate Expiration Date 11/8/2026
Facility Type Physician Office
Lab Director PAUL E. RITENOUR

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