Organization · Type 2 NPI

Western Reserve Masonic Community

Clinical Medical Laboratory · Medina, OH

NPI number 1740515865 Active

Practice location

4931 Nettleton Rd
Medina, OH 44256-5353

Specialties and licenses

Taxonomy	Code	License
Clinical Medical Laboratory Primary	291U00000X	36D1002841 (OH)

Clinical Medical Laboratory: (1) A clinical laboratory is a facility for the biological, microbiological, serological, chemical, immunohematological, hematological, biophysical, cytological, pathological, or other examination of materials derived from the human body for the purpose of providing information for the diagnosis, prevention, or treatment of any disease or impairment of, human beings. These examinations also include procedures to det…

6 other providers at this address

Other clinical medical laboratory providers in Medina

Shcp, Medina, Inc.Clinical Medical Laboratory Medina, OH NPI 1720380199

See all in Medina →

NPI record

NPI: 1740515865
Entity type: Organization (Type 2)
Issued: Oct 7, 2009
Last updated: Oct 7, 2009
Status: Active
Subpart: Yes of Ohio Masonic Home

Other names

<unavail>
Western Reserve Masonic Community - Laboratory · doing business as

Authorized official

Mr. Jay Dettorre
President
(330) 721-3000

Verify this record

This page mirrors the public NPPES file. For credentialing or billing, confirm it on the official CMS NPI Registry, and check the license with the state board.

Is this your record? How to update it.

About NPI 1740515865

Western Reserve Masonic Community's National Provider Identifier is 1740515865, issued on Oct 7, 2009. The primary taxonomy on file is Clinical Medical Laboratory (291U00000X), and the practice location is in Medina, OH. The record was last updated on Oct 7, 2009.