15D0358121 CLIA NUMBER - EAST ROCKETS HH, LLC DBA HEARTLAND HOME HEALTH (FT WAYNE)

Laboratory Demographics

  • CLIA Code: 15D0358121
  • Facility Name: EAST ROCKETS HH, LLC DBA HEARTLAND HOME HEALTH (FT WAYNE)
  • Facility Address: 2720 DUPONT COMMERCE CT, SUITE 130
    FORT WAYNE, IN
    ZIP 46825
  • Facility Phone: 260 484-6818
  • Facility Type: Home Health Agency
  • Facility Type: Waiver
  • Lab Director: SELECE BEASLEY
  • NPI Number: 1265158588
  • Taxonomy: 207RH0002X - Internal Medicine

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CLIA Record

Field Name Field Value
CLIA Number 15D0358121
LAB Type Home Health Agency
Facility Name EAST ROCKETS HH, LLC DBA HEARTLAND HOME HEALTH (FT WAYNE)
Street 2720 DUPONT COMMERCE CT, SUITE 130
City FORT WAYNE
State IN
ZIP 46825
Phone 260 484-6818
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/1/2024
Certificate Expiration Date 9/30/2026
Facility Type Home Health Agency
Lab Director SELECE BEASLEY

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This page was last updated on: 9/29/2025