36D2200372 CLIA NUMBER - SOCIETY FOR HANDICAPPED CITIZENS, THE OF MEDINA COUNTY, INC

Laboratory Demographics

CLIA Code: 36D2200372
Facility Name: SOCIETY FOR HANDICAPPED CITIZENS, THE OF MEDINA COUNTY, INC
Facility Address: 4283 PARADISE RD
SEVILLE, OH
ZIP 44273
Facility Phone: 216 408-0057
Facility Type: Intermediate Care Facility for Mentally Retarded
Facility Type: Waiver
Lab Director: ANTHONY KIRKBY
NPI Number: 1104039213
Taxonomy: 320900000X - Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities

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CLIA Record

Field Name	Field Value
CLIA Number	36D2200372
LAB Type	Intermediate Care Facility for Mentally Retarded
Facility Name	SOCIETY FOR HANDICAPPED CITIZENS, THE OF MEDINA COUNTY, INC
Street	4283 PARADISE RD
City	SEVILLE
State	OH
ZIP	44273
Phone	216 408-0057
Certificate Type	Certificate of Waiver
Certificate Type Description	This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date	11/16/2024
Certificate Expiration Date	11/15/2026
Facility Type	Intermediate Care Facility for Mentally Retarded
Lab Director	ANTHONY KIRKBY

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