36D2305762 CLIA NUMBER - MEDAVI TREATMENT, LLC

Laboratory Demographics

  • CLIA Code: 36D2305762
  • Facility Name: MEDAVI TREATMENT, LLC
  • Facility Address: 6629 W CENTRAL AVE
    TOLEDO, OH
    ZIP 43617
  • Facility Phone: 567 288-2087
  • Facility Type: Comp. Outpatient Rehab Facility
  • Facility Type: Waiver
  • Lab Director: KENNETH ADLER
  • NPI Number: 1174389597
  • Taxonomy: 261QR0405X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 36D2305762
LAB Type Comp. Outpatient Rehab Facility
Facility Name MEDAVI TREATMENT, LLC
Street 6629 W CENTRAL AVE
City TOLEDO
State OH
ZIP 43617
Phone 567 288-2087
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 6/5/2024
Certificate Expiration Date 6/4/2026
Facility Type Comp. Outpatient Rehab Facility
Lab Director KENNETH ADLER

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This page was last updated on: 6/4/2025