15D0720872 CLIA NUMBER - MAJESTIC CARE OF FORT WAYNE

Laboratory Demographics

  • CLIA Code: 15D0720872
  • Facility Name: MAJESTIC CARE OF FORT WAYNE
  • Facility Address: 7519 WINCHESTER RD
    FORT WAYNE, IN
    ZIP 46819
  • Facility Phone: 260 747-7435
  • Facility Type: Skilled Nursing Facility/Nursing Facility
  • Facility Type: Waiver
  • Lab Director: JAMI MOORE
  • NPI Number: 1235177981
  • Taxonomy: 314000000X - Skilled Nursing Facility

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CLIA Record

Field Name Field Value
CLIA Number 15D0720872
LAB Type Skilled Nursing Facility/Nursing Facility
Facility Name MAJESTIC CARE OF FORT WAYNE
Street 7519 WINCHESTER RD
City FORT WAYNE
State IN
ZIP 46819
Phone 260 747-7435
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 JAMI MOORE

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