CLIA lab
CLIA 36D2066880: Country Club Retirement Center V LLC
Delaware, OH. Certificate and address details from the CMS Provider of Services file for clinical laboratories.
CLIA number 36D2066880 belongs to Country Club Retirement Center V LLC in Delaware, OH.
Certificate of Waiver, effective October 4, 2025, expires October 3, 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
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Certificate
- Certificate type
- Certificate of Waiver
- Certificate effective
- October 4, 2025
- Certificate expiration
- October 3, 2027
- Status in the CMS file
- Active (termination code 00)
- Original participation date
- October 4, 2013
- Facility type
- Skilled nursing or nursing facility
- Ownership (control type)
- Proprietary
- Lab classification
- CLIA laboratory
Source: CMS Provider of Services File, Clinical Laboratories (CLIA), as of October 16, 2026. Publisher page
Lab and contact
- CLIA number
- 36D2066880
- Lab name
- Country Club Retirement Center V LLC
- Address
- 478 South Sandusky St, Delaware, OH 43015
- Phone
- (740) 369-8741
- Fax
- (740) 363-8359
Annual test volume the lab reported
- Waived tests
- 40,000
Volumes are what the lab reported to CMS on its CMS-116 application, as carried in the file.
Care facility at this address
- Country Club Center V, IncCMS Care Compare ratings for the facility at the same street address
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Related
Questions
What is the CLIA number for Country Club Retirement Center V LLC in Delaware?
36D2066880, per the CMS Provider of Services file posted October 16, 2026.
What CLIA certificate does Country Club Retirement Center V LLC hold?
A Certificate of Waiver, according to the CMS file.
When does CLIA 36D2066880 expire?
The CMS file lists October 3, 2027 as the certificate expiration date; the certificate took effect October 4, 2025.