15D0647515 CLIA NUMBER - LUTHERAN LIFE VILLAGES

Laboratory Demographics

  • CLIA Code: 15D0647515
  • Facility Name: LUTHERAN LIFE VILLAGES
  • Facility Address: 6701 S ANTHONY BLVD
    FORT WAYNE, IN
    ZIP 46816
  • Facility Phone: (219) 447-1591
  • Facility Type: Skilled Nursing Facility/Nursing Facility
  • Facility Type: Waiver
  • Lab Director: MS. SYLVIA PAGE
  • NPI Number: 1073554200
  • Taxonomy: 314000000X - Skilled Nursing Facility

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CLIA Record

Field Name Field Value
CLIA Number 15D0647515
LAB Type Skilled Nursing Facility/Nursing Facility
Facility Name LUTHERAN LIFE VILLAGES
Street 6701 S ANTHONY BLVD
City FORT WAYNE
State IN
ZIP 46816
Phone 2194471591
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 MS. SYLVIA PAGE

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This page was last updated on: 5/18/2026