15D0362479 CLIA NUMBER - GREEN HILL MANOR

Laboratory Demographics

  • CLIA Code: 15D0362479
  • Facility Name: GREEN HILL MANOR
  • Facility Address: 501 N LINCOLN AVE
    FOWLER, IN
    ZIP 47944
  • Facility Phone: 765 884-1470
  • Facility Type: Skilled Nursing Facility/Nursing Facility
  • Facility Type: Waiver
  • Lab Director: STEPHANIE S. ANDERSON
  • NPI Number: 1255484937
  • Taxonomy: 314000000X - Skilled Nursing Facility

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CLIA Record

Field Name Field Value
CLIA Number 15D0362479
LAB Type Skilled Nursing Facility/Nursing Facility
Facility Name GREEN HILL MANOR
Street 501 N LINCOLN AVE
City FOWLER
State IN
ZIP 47944
Phone 765 884-1470
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/1/2024
Certificate Expiration Date 8/31/2026
Facility Type Skilled Nursing Facility/Nursing Facility
Lab Director STEPHANIE S. ANDERSON

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