15D0717005 CLIA NUMBER - MAJESTIC CARE OF GOSHEN

Laboratory Demographics

  • CLIA Code: 15D0717005
  • Facility Name: MAJESTIC CARE OF GOSHEN
  • Facility Address: 2400 COLLEGE AVE
    GOSHEN, IN
    ZIP 46526
  • Facility Phone: 574 533-0351
  • Facility Type: Skilled Nursing Facility/Nursing Facility
  • Facility Type: Waiver
  • Lab Director: BRIAN COOK
  • NPI Number: 1609977628
  • Taxonomy: 314000000X - Skilled Nursing Facility

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CLIA Record

Field Name Field Value
CLIA Number 15D0717005
LAB Type Skilled Nursing Facility/Nursing Facility
Facility Name MAJESTIC CARE OF GOSHEN
Street 2400 COLLEGE AVE
City GOSHEN
State IN
ZIP 46526
Phone 574 533-0351
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 BRIAN COOK

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