15D0861525 CLIA NUMBER - ST PAULS

Laboratory Demographics

  • CLIA Code: 15D0861525
  • Facility Name: ST PAULS
  • Facility Address: 3602 S IRONWOOD DR
    SOUTH BEND, IN
    ZIP 46614
  • Facility Phone: 219 291-8205
  • Facility Type: Assisted Living Facility
  • Facility Type: Waiver
  • Lab Director: JEFFRY BILLHIMER
  • NPI Number: 1609869064
  • Taxonomy: 314000000X - Skilled Nursing Facility

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CLIA Record

Field Name Field Value
CLIA Number 15D0861525
LAB Type Assisted Living Facility
Facility Name ST PAULS
Street 3602 S IRONWOOD DR
City SOUTH BEND
State IN
ZIP 46614
Phone 219 291-8205
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 Assisted Living Facility
Lab Director JEFFRY BILLHIMER

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