15D1044402 CLIA NUMBER - WABASH CENTER, INC

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Field Name	Field Value
CLIA Number	15D1044402
LAB Type	Intermediate Care Facility for Mentally Retarded
Facility Name	WABASH CENTER, INC
Street	2000 GREENBUSH STREET
City	LAFAYETTE
State	IN
ZIP	47904
Phone	765 423-5531
Certificate Type	Certificate of Waiver
Certificate Type Description	This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date	1/26/2025
Certificate Expiration Date	1/25/2027
Facility Type	Intermediate Care Facility for Mentally Retarded
Lab Director	JASON P. MCMANUS

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