36D2274220 CLIA NUMBER - GENOA HEALTHCARE LLC

Laboratory Demographics

CLIA Number: 36D2274220

Facility Name: GENOA HEALTHCARE LLC

Facility Address:
3909 WOODLEY RD, STE 450
TOLEDO, OH
ZIP 43606
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Facility Phone Number: 419 517-1317

Facility Type: Pharmacy

Certificate Type: Waiver

NPI Number: 1871538447

Taxonomy: 3336L0003X - Pharmacy
A pharmacy that dispenses medicinal preparations delivered to patients residing within an intermediate or skilled nursing facility, including intermediate care facilities, hospice, assisted living facilities, group homes, and other forms of congregate living arrangements.

CLIA Record

Field Name	Field Value
CLIA Number	36D2274220
LAB Type	Pharmacy
Facility Name	GENOA HEALTHCARE LLC
Street	3909 WOODLEY RD, STE 450
City	TOLEDO
State	OH
ZIP	43606
Phone	419 517-1317
CertificateType	4
CertificateEffectiveDate	12/28/2022
CertificateExpirationDate	12/27/2024
FacilityType	Waiver

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This page was last updated on: 4/23/2024