15D0719444 CLIA NUMBER - MITCHELL MANOR

Laboratory Demographics

  • CLIA Code: 15D0719444
  • Facility Name: MITCHELL MANOR
  • Facility Address: 24 TEKE BURTON DRIVE
    MITCHELL, IN
    ZIP 47446
  • Facility Phone: (812) 849-2221
  • Facility Type: Skilled Nursing Facility/Nursing Facility
  • Facility Type: Waiver
  • Lab Director: AMANDA D. SIMMERMAN
  • NPI Number: 1972550036
  • Taxonomy: 314000000X - Skilled Nursing Facility

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CLIA Record

Field Name Field Value
CLIA Number 15D0719444
LAB Type Skilled Nursing Facility/Nursing Facility
Facility Name MITCHELL MANOR
Street 24 TEKE BURTON DRIVE
City MITCHELL
State IN
ZIP 47446
Phone 8128492221
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 AMANDA D. SIMMERMAN

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This page was last updated on: 5/18/2026