15D1066615 CLIA NUMBER - FOREST PARK HEALTH CAMPUS

Laboratory Demographics

  • CLIA Code: 15D1066615
  • Facility Name: FOREST PARK HEALTH CAMPUS
  • Facility Address: 2401 S L ST
    RICHMOND, IN
    ZIP 47374
  • Facility Phone: 765 966-5705
  • Facility Type: Skilled Nursing Facility/Nursing Facility
  • Facility Type: Waiver
  • Lab Director: SHELLY R. EARLYWINE
  • NPI Number: 1710076823
  • Taxonomy: 314000000X - Skilled Nursing Facility

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CLIA Record

Field Name Field Value
CLIA Number 15D1066615
LAB Type Skilled Nursing Facility/Nursing Facility
Facility Name FOREST PARK HEALTH CAMPUS
Street 2401 S L ST
City RICHMOND
State IN
ZIP 47374
Phone 765 966-5705
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/28/2025
Certificate Expiration Date 3/27/2027
Facility Type Skilled Nursing Facility/Nursing Facility
Lab Director SHELLY R. EARLYWINE

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