36D2243311 CLIA NUMBER - ST JOHN'S VILLA

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CLIA Record

Field Name Field Value
CLIA Number 36D2243311
LAB Type Intermediate Care Facility for Mentally Retarded
Facility Name ST JOHN'S VILLA
Street 701 CREST ST NW
City CARROLLTON
State OH
ZIP 44615
Phone 330 627-9789
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 11/17/2023
Certificate Expiration Date 11/16/2025
Facility Type Intermediate Care Facility for Mentally Retarded
Lab Director VALERIE HUFF

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