15D1050284 CLIA NUMBER - CEDAR CREEK OF FORT WAYNE

Laboratory Demographics

  • CLIA Code: 15D1050284
  • Facility Name: CEDAR CREEK OF FORT WAYNE
  • Facility Address: 2116 BUTLER ROAD
    FORT WAYNE, IN
    ZIP 46808
  • Facility Phone: 260 471-0944
  • Facility Type: Assisted Living Facility
  • Facility Type: Waiver
  • Lab Director: BELINDA BRANHAM
  • NPI Number: 1093900672
  • Taxonomy: 310400000X - Assisted Living Facility

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CLIA Record

Field Name Field Value
CLIA Number 15D1050284
LAB Type Assisted Living Facility
Facility Name CEDAR CREEK OF FORT WAYNE
Street 2116 BUTLER ROAD
City FORT WAYNE
State IN
ZIP 46808
Phone 260 471-0944
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 1/30/2024
Certificate Expiration Date 1/29/2026
Facility Type Assisted Living Facility
Lab Director BELINDA BRANHAM

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