36D2297493 CLIA NUMBER - GORDRELL ENTERPRISES LLC

Laboratory Demographics

  • CLIA Code: 36D2297493
  • Facility Name: GORDRELL ENTERPRISES LLC
  • Facility Address: 5150 E MAIN ST (LOWER LEVEL)
    COLUMBUS, OH
    ZIP 43213
  • Facility Phone: 614 604-8274
  • Facility Type: Other - MENTAL HEALTH OUTPATIENT
  • Facility Type: Waiver
  • Lab Director: TOMIKA N. GORDON
  • NPI Number: 1013521178
  • Taxonomy: 343900000X - Non-emergency Medical Transport (VAN)

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CLIA Record

Field Name Field Value
CLIA Number 36D2297493
LAB Type Other - MENTAL HEALTH OUTPATIENT
Facility Name GORDRELL ENTERPRISES LLC
Street 5150 E MAIN ST (LOWER LEVEL)
City COLUMBUS
State OH
ZIP 43213
Phone 614 604-8274
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 1/17/2024
Certificate Expiration Date 1/16/2026
Facility Type Other - MENTAL HEALTH OUTPATIENT
Lab Director TOMIKA N. GORDON

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