36D2254106 CLIA NUMBER - EMILY PROGRAM - COLUMBUS OUTPATIENT, THE

Laboratory Demographics

  • CLIA Code: 36D2254106
  • Facility Name: EMILY PROGRAM - COLUMBUS OUTPATIENT, THE
  • Facility Address: 8001 RAVINES EDGE CT #301
    COLUMBUS, OH
    ZIP 43235
  • Facility Phone: 888 364-5977
  • Facility Type: Other - RESIDENTIAL TRTMT, EATING
  • Facility Type: Waiver
  • Lab Director: SARAH BERGEN
  • NPI Number: 1669444329
  • Taxonomy: 261QM0801X - Clinic/Center

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 36D2254106
LAB Type Other - RESIDENTIAL TRTMT, EATING
Facility Name EMILY PROGRAM - COLUMBUS OUTPATIENT, THE
Street 8001 RAVINES EDGE CT #301
City COLUMBUS
State OH
ZIP 43235
Phone 888 364-5977
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 2/29/2024
Certificate Expiration Date 2/27/2026
Facility Type Other - RESIDENTIAL TRTMT, EATING
Lab Director SARAH BERGEN

Download Record

Download this CLIA record record in Text format: Export

Download this CLIA record record in Excel (CSV) format: Export

Download this CLIA record record in XML format: Export

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