36D2308386 CLIA NUMBER - WHITE LIGHT BEHAVIORAL HEALTH

Laboratory Demographics

  • CLIA Code: 36D2308386
  • Facility Name: WHITE LIGHT BEHAVIORAL HEALTH
  • Facility Address: 4300 EAST BROAD STREET, 3RD FLOOR
    COLUMBUS, OH
    ZIP 43213
  • Facility Phone: 614 705-2767
  • Facility Type: Other - DAY TREATMENT PROGRAM
  • Facility Type: Waiver
  • Lab Director: RYAN WAKIM
  • NPI Number: 1295573921
  • Taxonomy: 261QM0850X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 36D2308386
LAB Type Other - DAY TREATMENT PROGRAM
Facility Name WHITE LIGHT BEHAVIORAL HEALTH
Street 4300 EAST BROAD STREET, 3RD FLOOR
City COLUMBUS
State OH
ZIP 43213
Phone 614 705-2767
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 7/26/2024
Certificate Expiration Date 7/25/2026
Facility Type Other - DAY TREATMENT PROGRAM
Lab Director RYAN WAKIM

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