36D2210277 CLIA NUMBER - COUNTRY CLUB OF MT VERNON

Laboratory Demographics

  • CLIA Code: 36D2210277
  • Facility Name: COUNTRY CLUB OF MT VERNON
  • Facility Address: 1350 YAUGER ROAD
    MOUNT VERNON, OH
    ZIP 43050
  • Facility Phone: 740 397-2350
  • Facility Type: Assisted Living Facility
  • Facility Type: Waiver
  • Lab Director: WHITNEY KANDELL
  • NPI Number: 1598831869
  • Taxonomy: 314000000X - Skilled Nursing Facility

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CLIA Record

Field Name Field Value
CLIA Number 36D2210277
LAB Type Assisted Living Facility
Facility Name COUNTRY CLUB OF MT VERNON
Street 1350 YAUGER ROAD
City MOUNT VERNON
State OH
ZIP 43050
Phone 740 397-2350
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 1/20/2025
Certificate Expiration Date 1/19/2027
Facility Type Assisted Living Facility
Lab Director WHITNEY KANDELL

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