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ST. LUKE LUTHERAN COMMUNITY-MINERVA
NPI 1295009710
Assisted Living Facility in Minerva, OH

Active since March 01, 2012CLIA 36D2199620 · Waiver
4301 WOODALE AVE SE, MINERVA, OH 44657(330) 499-8341(330) 497-6141 Get Directions Write a Review

NPPES record last updated: March 1, 2012. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About St. Luke Lutheran Community-minerva NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

ST. LUKE LUTHERAN COMMUNITY-MINERVA (NPI 1295009710) is a healthcare organization registered as an assisted living facility in Minerva, Ohio and active in the NPI registry since March 2012. The organization holds a CLIA Waiver certificate valid through November 9, 2026 and lists Ronald E Derry, Cfo, as its authorized official.

NPPES Registry Identity

NPI1295009710
Entity TypeOrganization
Primary Taxonomy310400000X
Legal Business NameST. LUKE LUTHERAN COMMUNITY-MINERVA
Location Address4301 WOODALE AVE SEMinerva, OH 44657-8923
Mailing Address220 Applegrove St NeNorth Canton, OH 44720-1610 · (330) 499-8341 · Fax (330) 497-6141
Phone(330) 499-8341
Fax(330) 497-6141
Organization SubpartNo
Authorized OfficialRonald E DerryCfo · (330) 966-5619
Enumeration DateMarch 1, 2012
✔ NPI 1295009710 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyAssisted Living FacilityNursing & Custodial Care Facilities
Taxonomy Code310400000X
Definition
A facility providing supportive services to individuals who can function independently in most areas of activity, but need assistance and/or monitoring to assure safety and well being.
4301 WOODALE AVE SE, Minerva, OH 44657
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CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 36D2199620

St Luke Lutheran Community - Minerva · Minerva, OH
Active · expires Nov 9, 2026
CLIA Number36D2199620
Laboratory TypeAssisted Living Facility
Certificate Effective DateNovember 10, 2024
Certificate Expiration DateNovember 9, 2026
Laboratory DirectorKaitlyn Mickley
Laboratory Phone(330) 868-5600
Laboratory LocationSt Luke Lutheran Community - Minerva4301 Woodale Ave SE, Minerva, OH 44657
CLIA data matches this NPI record on: Address Name
This certificate is issued to a laboratory to perform only waived tests.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is St. Luke Lutheran Community-Minerva's NPI number?

The NPI number for St. Luke Lutheran Community-Minerva is 1295009710. It was assigned to this organization in the NPPES registry on March 1, 2012.

Where is St. Luke Lutheran Community-Minerva located?

St. Luke Lutheran Community-Minerva is located at 4301 Woodale Ave SE, Minerva, OH 44657. The listed phone number is (330) 499-8341.

What is St. Luke Lutheran Community-Minerva's specialty?

The primary specialty registered for this NPI is Assisted Living Facility with taxonomy code 310400000X.

Does St. Luke Lutheran Community-Minerva hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 36D2199620) is associated with this NPI, valid through November 9, 2026. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for St. Luke Lutheran Community-Minerva was last updated on March 1, 2012. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 14 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.