15D0907421 CLIA NUMBER - RANDOLPH NURSING HOME

Laboratory Demographics

  • CLIA Code: 15D0907421
  • Facility Name: RANDOLPH NURSING HOME
  • Facility Address: 701 SOUTH OAK STREET
    WINCHESTER, IN
    ZIP 47394
  • Facility Phone: 765 584-2201
  • Facility Type: Skilled Nursing Facility/Nursing Facility
  • Facility Type: Waiver
  • Lab Director: ALISON SYME
  • NPI Number: 1841285913
  • Taxonomy: 314000000X - Skilled Nursing Facility

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CLIA Record

Field Name Field Value
CLIA Number 15D0907421
LAB Type Skilled Nursing Facility/Nursing Facility
Facility Name RANDOLPH NURSING HOME
Street 701 SOUTH OAK STREET
City WINCHESTER
State IN
ZIP 47394
Phone 765 584-2201
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/13/2023
Certificate Expiration Date 10/12/2025
Facility Type Skilled Nursing Facility/Nursing Facility
Lab Director ALISON SYME

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