15D0723705 CLIA NUMBER - LIFE CARE CENTER OF FORT WAYNE

Laboratory Demographics

  • CLIA Code: 15D0723705
  • Facility Name: LIFE CARE CENTER OF FORT WAYNE
  • Facility Address: 1649 SPY RUN AVENUE
    FORT WAYNE, IN
    ZIP 46805
  • Facility Phone: 260 422-8520
  • Facility Type: Skilled Nursing Facility/Nursing Facility
  • Facility Type: Waiver
  • Lab Director: DAWN D. ALMOND
  • NPI Number: 1700833670
  • Taxonomy: 314000000X - Skilled Nursing Facility

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 15D0723705
LAB Type Skilled Nursing Facility/Nursing Facility
Facility Name LIFE CARE CENTER OF FORT WAYNE
Street 1649 SPY RUN AVENUE
City FORT WAYNE
State IN
ZIP 46805
Phone 260 422-8520
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 DAWN D. ALMOND

Download Record

Download this CLIA record record in Text format: Export

Download this CLIA record record in Excel (CSV) format: Export

Download this CLIA record record in XML format: Export

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