CLIA lab
CLIA 36D1019043: Mental Health Services for Clark and
Springfield, OH. Certificate and address details from the CMS Provider of Services file for clinical laboratories.
CLIA number 36D1019043 belongs to Mental Health Services for Clark and in Springfield, OH.
Certificate of Waiver, effective November 10, 2025, expires November 9, 2027.
Active in the CMS Provider of Services file posted October 16, 2026.
Source: CMS Provider of Services File, Clinical Laboratories (CLIA), as of October 16, 2026. Publisher page
Run it in Rivvi
Map your lab's test names to LOINC codes
Open in RivviFree to start. Opens Rivvi, the AI workspace for healthcare teams.
Certificate
- Certificate type
- Certificate of Waiver
- Certificate effective
- November 10, 2025
- Certificate expiration
- November 9, 2027
- Status in the CMS file
- Active (termination code 00)
- Original participation date
- November 10, 2003
- Facility type
- Other practitioner
- Ownership (control type)
- Private
- Lab classification
- CLIA laboratory
- Directly affiliated labs
- 4
Source: CMS Provider of Services File, Clinical Laboratories (CLIA), as of October 16, 2026. Publisher page
Lab and contact
- CLIA number
- 36D1019043
- Lab name
- Mental Health Services for Clark and
- Additional name
- Madison Counties, Inc
- Address
- 474 N Yellow Springs St, Springfield, OH 45504
- Phone
- (937) 629-3046
- Fax
- (937) 342-4242
Annual test volume the lab reported
- Waived tests
- 52
Volumes are what the lab reported to CMS on its CMS-116 application, as carried in the file.
Affiliated CLIA numbers
Other labs in Springfield, OH
- Advanced Nephrology & HypertensionCertificate of Waiver, Physician office36D2106046
- Aeg Ohio Professional PC DBACertificate of Waiver, Physician office36D2292212
- Ajaz Umerani MD IncCertificate of Waiver, Physician office36D0935849
- Anew Behavioral Health, LLCCertificate of Waiver, Other36D2290397
- Anew Behavioral Health, LLCCertificate of Waiver, Other36D2344313
- Autumn Behavioral Health CenterCertificate of Waiver, Community clinic36D2337746
- Brightview, LLC - SpringfieldCertificate of Waiver, Physician office36D2166385
- Brookdale Buck CreekCertificate of Waiver, Assisted living facility36D2054350
- Challa Ajit MD LLCCertificate of Waiver, Physician office36D1062943
- Champion City Home Health Care LLCCertificate of Waiver, Home health agency36D2255404
Related
Questions
What is the CLIA number for Mental Health Services for Clark and in Springfield?
36D1019043, per the CMS Provider of Services file posted October 16, 2026.
What CLIA certificate does Mental Health Services for Clark and hold?
A Certificate of Waiver, according to the CMS file.
When does CLIA 36D1019043 expire?
The CMS file lists November 9, 2027 as the certificate expiration date; the certificate took effect November 10, 2025.