36D2202245 CLIA NUMBER - KOINONIA HOMES

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Field Name	Field Value
CLIA Number	36D2202245
LAB Type	Intermediate Care Facility for Mentally Retarded
Facility Name	KOINONIA HOMES
Street	6161 OAK TREE BLVD, SUITE 400
City	INDEPENDENCE
State	OH
ZIP	44131
Phone	216 217-1356
Certificate Type	Certificate of Waiver
Certificate Type Description	This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date	11/25/2024
Certificate Expiration Date	11/24/2026
Facility Type	Intermediate Care Facility for Mentally Retarded
Lab Director	JEANNE L. GREENE

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