15D0663360 CLIA NUMBER - MILLERS MERRY MANOR

Laboratory Demographics

  • CLIA Code: 15D0663360
  • Facility Name: MILLERS MERRY MANOR
  • Facility Address: 5909 LUTE RD
    PORTAGE, IN
    ZIP 46368
  • Facility Phone: 219 763-2273
  • Facility Type: Skilled Nursing Facility/Nursing Facility
  • Facility Type: Waiver
  • Lab Director: KAREN WHITE
  • NPI Number: 1669495008
  • Taxonomy: 314000000X - Skilled Nursing Facility

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CLIA Record

Field Name Field Value
CLIA Number 15D0663360
LAB Type Skilled Nursing Facility/Nursing Facility
Facility Name MILLERS MERRY MANOR
Street 5909 LUTE RD
City PORTAGE
State IN
ZIP 46368
Phone 219 763-2273
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 KAREN WHITE

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