15D0710709 CLIA NUMBER - MAJESTIC CARE OF WEST ALLEN

Laboratory Demographics

  • CLIA Code: 15D0710709
  • Facility Name: MAJESTIC CARE OF WEST ALLEN
  • Facility Address: 6050 S CR 800 E 92
    FORT WAYNE, IN
    ZIP 46814
  • Facility Phone: 260 625-3545
  • Facility Type: Skilled Nursing Facility/Nursing Facility
  • Facility Type: Waiver
  • Lab Director: ANGELICA YANEZ
  • NPI Number: 1336548353
  • Taxonomy: 314000000X - Skilled Nursing Facility

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CLIA Record

Field Name Field Value
CLIA Number 15D0710709
LAB Type Skilled Nursing Facility/Nursing Facility
Facility Name MAJESTIC CARE OF WEST ALLEN
Street 6050 S CR 800 E 92
City FORT WAYNE
State IN
ZIP 46814
Phone 260 625-3545
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 ANGELICA YANEZ

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