36D2277175 CLIA NUMBER - SQUARE ONE HEALTH, LLC

Laboratory Demographics

  • CLIA Code: 36D2277175
  • Facility Name: SQUARE ONE HEALTH, LLC
  • Facility Address: 3225 LAKE AVENUE
    ASHTABULA, OH
    ZIP 44004
  • Facility Phone: 440 650-5030
  • Facility Type: Comp. Outpatient Rehab Facility
  • Facility Type: Waiver
  • Lab Director: KRISTY L. HOSKEN
  • NPI Number: 1326717190
  • Taxonomy: 251S00000X - Community/Behavioral Health

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CLIA Record

Field Name Field Value
CLIA Number 36D2277175
LAB Type Comp. Outpatient Rehab Facility
Facility Name SQUARE ONE HEALTH, LLC
Street 3225 LAKE AVENUE
City ASHTABULA
State OH
ZIP 44004
Phone 440 650-5030
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 2/22/2025
Certificate Expiration Date 2/21/2027
Facility Type Comp. Outpatient Rehab Facility
Lab Director KRISTY L. HOSKEN

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