36D2219900 CLIA NUMBER - BEACON BEHAVIORAL HEALTH SERVICES

Laboratory Demographics

  • CLIA Code: 36D2219900
  • Facility Name: BEACON BEHAVIORAL HEALTH SERVICES
  • Facility Address: 114 N WOOD ST
    FREMONT, OH
    ZIP 43420
  • Facility Phone: 567 201-2048
  • Facility Type: Practitioner Other
  • Facility Type: Waiver
  • Lab Director: MELISSA TESTER
  • NPI Number: 1891374930
  • Taxonomy: 251S00000X - Community/Behavioral Health

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CLIA Record

Field Name Field Value
CLIA Number 36D2219900
LAB Type Practitioner Other
Facility Name BEACON BEHAVIORAL HEALTH SERVICES
Street 114 N WOOD ST
City FREMONT
State OH
ZIP 43420
Phone 567 201-2048
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/8/2025
Certificate Expiration Date 4/7/2027
Facility Type Practitioner Other
Lab Director MELISSA TESTER

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This page was last updated on: 6/4/2025