15D0647726 CLIA NUMBER - RICHLAND BEAN BLOSSOM HEALTH CARE CTR

Laboratory Demographics

  • CLIA Code: 15D0647726
  • Facility Name: RICHLAND BEAN BLOSSOM HEALTH CARE CTR
  • Facility Address: 5911 W SR 46 PO BOX 537
    ELLETTSVILLE, IN
    ZIP 47429
  • Facility Phone: 812 876-6400
  • Facility Type: Skilled Nursing Facility/Nursing Facility
  • Facility Type: Waiver
  • Lab Director: CAROLYN R. GRUBB
  • NPI Number: 1659366128
  • Taxonomy: 314000000X - Skilled Nursing Facility

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CLIA Record

Field Name Field Value
CLIA Number 15D0647726
LAB Type Skilled Nursing Facility/Nursing Facility
Facility Name RICHLAND BEAN BLOSSOM HEALTH CARE CTR
Street 5911 W SR 46 PO BOX 537
City ELLETTSVILLE
State IN
ZIP 47429
Phone 812 876-6400
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 CAROLYN R. GRUBB

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