15D0977601 CLIA NUMBER - KOKOMO PLACE ASSISTED LIVING

Laboratory Demographics

  • CLIA Code: 15D0977601
  • Facility Name: KOKOMO PLACE ASSISTED LIVING
  • Facility Address: 3025 W SYCAMORE ST
    KOKOMO, IN
    ZIP 46901
  • Facility Phone: 260 312-8082
  • Facility Type: Assisted Living Facility
  • Facility Type: Waiver
  • Lab Director: ANDREA STONESTREET
  • NPI Number: 1760937312
  • Taxonomy: 310400000X - Assisted Living Facility

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CLIA Record

Field Name Field Value
CLIA Number 15D0977601
LAB Type Assisted Living Facility
Facility Name KOKOMO PLACE ASSISTED LIVING
Street 3025 W SYCAMORE ST
City KOKOMO
State IN
ZIP 46901
Phone 260 312-8082
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/30/2024
Certificate Expiration Date 8/29/2026
Facility Type Assisted Living Facility
Lab Director ANDREA STONESTREET

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This page was last updated on: 6/4/2025