15D0907250 CLIA NUMBER - PEAK COMMUNITY SERVICES

Laboratory Demographics

CLIA Code: 15D0907250
Facility Name: PEAK COMMUNITY SERVICES
Facility Address: 1416 WOODLAWN AVE
LOGANSPORT, IN
ZIP 46947
Facility Phone: 574 753-4104
Facility Type: Intermediate Care Facility for Mentally Retarded
Facility Type: Waiver
Lab Director: CHRISTOPHER J. NABORS
NPI Number: 1316260441
Taxonomy: 320600000X - Residential Treatment Facility, Intellectual and/or Developmental Disabilities

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CLIA Record

Field Name	Field Value
CLIA Number	15D0907250
LAB Type	Intermediate Care Facility for Mentally Retarded
Facility Name	PEAK COMMUNITY SERVICES
Street	1416 WOODLAWN AVE
City	LOGANSPORT
State	IN
ZIP	46947
Phone	574 753-4104
Certificate Type	Certificate of Waiver
Certificate Type Description	This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date	2/8/2024
Certificate Expiration Date	2/7/2026
Facility Type	Intermediate Care Facility for Mentally Retarded
Lab Director	CHRISTOPHER J. NABORS

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