15D1037082 CLIA NUMBER - WHITLOCK PLACE

Laboratory Demographics

  • CLIA Code: 15D1037082
  • Facility Name: WHITLOCK PLACE
  • Facility Address: 1719 S ELM ST
    CRAWFORDSVILLE, IN
    ZIP 47933
  • Facility Phone: 765 364-1880
  • Facility Type: Assisted Living Facility
  • Facility Type: Waiver
  • Lab Director: LA SHA BATEMANE
  • NPI Number: 1487849063
  • Taxonomy: 310400000X - Assisted Living Facility

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CLIA Record

Field Name Field Value
CLIA Number 15D1037082
LAB Type Assisted Living Facility
Facility Name WHITLOCK PLACE
Street 1719 S ELM ST
City CRAWFORDSVILLE
State IN
ZIP 47933
Phone 765 364-1880
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 2/15/2025
Certificate Expiration Date 2/14/2027
Facility Type Assisted Living Facility
Lab Director LA SHA BATEMANE

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