15D1036828 CLIA NUMBER - LOGANSPORT AL, LLC D/B/A CEDAR CREEK OF LOGANSPORT

Laboratory Demographics

  • CLIA Code: 15D1036828
  • Facility Name: LOGANSPORT AL, LLC D/B/A CEDAR CREEK OF LOGANSPORT
  • Facility Address: 3901 HIGH STREET
    LOGANSPORT, IN
    ZIP 46947
  • Facility Phone: 574 739-2134
  • Facility Type: Assisted Living Facility
  • Facility Type: Waiver
  • Lab Director: JENNIFER E. POOLE
  • NPI Number: 1770778359
  • Taxonomy: 310400000X - Assisted Living Facility

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CLIA Record

Field Name Field Value
CLIA Number 15D1036828
LAB Type Assisted Living Facility
Facility Name LOGANSPORT AL, LLC D/B/A CEDAR CREEK OF LOGANSPORT
Street 3901 HIGH STREET
City LOGANSPORT
State IN
ZIP 46947
Phone 574 739-2134
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 2/10/2025
Certificate Expiration Date 2/9/2027
Facility Type Assisted Living Facility
Lab Director JENNIFER E. POOLE

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