OrganizationActive
Western Reserve Masonic Community
NPI 1740515865 · Clinical Medical Laboratory · Medina, OH
Western Reserve Masonic Community is a Clinical Medical Laboratory organization in Medina, OH (NPI 1740515865).
Provider details
- NPI number
- 1740515865
- Entity type
- Organization
- Primary specialty
- Clinical Medical LaboratoryLaboratories
- Parent organization
- Ohio Masonic Home
- Organization subpart
- Yes
- Authorized official
- Jay Dettorre, President(330) 721-3000
- License
- 36D1002841 (OH)
Specialties & taxonomies
Laboratories
Profile Score
Detailed profile(84/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
16 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
4931 Nettleton Rd
Medina, OH 44256-5353
Phone: (330) 721-3000
Street-level locationGet directions
Mailing address
4931 Nettleton Rd
Medina, OH 44256-5353
Other names (DBA / former)
- Doing business as
- Western Reserve Masonic Community - Laboratory
Registry dates
- Enumerated
- 2009-10-07
- Last updated
- 2009-10-07
Frequently asked questions
- What is Western Reserve Masonic Community's NPI number?
- Western Reserve Masonic Community's National Provider Identifier (NPI) is 1740515865, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What type of organization is Western Reserve Masonic Community?
- Western Reserve Masonic Community is classified in the NPPES registry as Clinical Medical Laboratory (Laboratories).
- Where is Western Reserve Masonic Community located?
- Western Reserve Masonic Community's practice location on file with NPPES is 4931 Nettleton Rd, Medina, OH 44256-5353.
- What is Western Reserve Masonic Community's phone number?
- The practice phone number listed in the NPPES registry for Western Reserve Masonic Community is (330) 721-3000.
- Who is the authorized official for Western Reserve Masonic Community?
- The authorized official listed on Western Reserve Masonic Community's NPPES record is Jay Dettorre, President. The authorized official registers and maintains the organization's NPI and is not necessarily its owner.
- Is Western Reserve Masonic Community's NPI active?
- Yes — Western Reserve Masonic Community's NPI (1740515865) is active in the NPPES registry as of the last update on 2009-10-07.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.