15D0681241 CLIA NUMBER - MAJESTIC CARE OF SOUTHPORT

Laboratory Demographics

  • CLIA Code: 15D0681241
  • Facility Name: MAJESTIC CARE OF SOUTHPORT
  • Facility Address: 8549 S MADISON AVE
    INDIANAPOLIS, IN
    ZIP 46227
  • Facility Phone: 317 881-9164
  • Facility Type: Skilled Nursing Facility/Nursing Facility
  • Facility Type: Waiver
  • Lab Director: RENITA MCCARLY
  • NPI Number: 1669410593
  • Taxonomy: 314000000X - Skilled Nursing Facility

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CLIA Record

Field Name Field Value
CLIA Number 15D0681241
LAB Type Skilled Nursing Facility/Nursing Facility
Facility Name MAJESTIC CARE OF SOUTHPORT
Street 8549 S MADISON AVE
City INDIANAPOLIS
State IN
ZIP 46227
Phone 317 881-9164
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 RENITA MCCARLY

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