15D0883120 CLIA NUMBER - THREE RIVERS AMBULANCE AUTHORITY

Laboratory Demographics

  • CLIA Code: 15D0883120
  • Facility Name: THREE RIVERS AMBULANCE AUTHORITY
  • Facility Address: 525 HAYDEN STNTON
    FORT WAYNE, IN
    ZIP 46802
  • Facility Phone: 219 420-6500
  • Facility Type: Other
  • Facility Type: Waiver
  • Lab Director: MICHAEL S. MANN
  • NPI Number: 1861499139
  • Taxonomy: 3416L0300X - Ambulance

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CLIA Record

Field Name Field Value
CLIA Number 15D0883120
LAB Type Other
Facility Name THREE RIVERS AMBULANCE AUTHORITY
Street 525 HAYDEN STNTON
City FORT WAYNE
State IN
ZIP 46802
Phone 219 420-6500
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 2/25/2024
Certificate Expiration Date 2/24/2026
Facility Type Other
Lab Director MICHAEL S. MANN

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