36D2323407 CLIA NUMBER - PHOENIX GROUP HOME LLC DBA PATH BEHAVIORAL HELTHCARE

Laboratory Demographics

  • CLIA Code: 36D2323407
  • Facility Name: PHOENIX GROUP HOME LLC DBA PATH BEHAVIORAL HELTHCARE
  • Facility Address: 122 WEST BROADWAY STREET
    NEW LEXINGTON, OH
    ZIP 43764
  • Facility Phone: 740 960-0380
  • Facility Type: Other - MENTAL HEALTH
  • Facility Type: Waiver
  • Lab Director: CHERYL BAILEY-SALARY
  • NPI Number: 1336654854
  • Taxonomy: 324500000X - Substance Abuse Rehabilitation Facility

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CLIA Record

Field Name Field Value
CLIA Number 36D2323407
LAB Type Other - MENTAL HEALTH
Facility Name PHOENIX GROUP HOME LLC DBA PATH BEHAVIORAL HELTHCARE
Street 122 WEST BROADWAY STREET
City NEW LEXINGTON
State OH
ZIP 43764
Phone 740 960-0380
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 5/7/2025
Certificate Expiration Date 5/6/2027
Facility Type Other - MENTAL HEALTH
Lab Director CHERYL BAILEY-SALARY

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