15D2018156 CLIA NUMBER - LOVING CARE AGENCY, INC D/B/A AVEANNA HEALTHCARE

Laboratory Demographics

  • CLIA Code: 15D2018156
  • Facility Name: LOVING CARE AGENCY, INC D/B/A AVEANNA HEALTHCARE
  • Facility Address: 111 EAST LUDWIG ROAD, SUITE 109
    FORT WAYNE, IN
    ZIP 46825
  • Facility Phone: 260 969-0100
  • Facility Type: Home Health Agency
  • Facility Type: Waiver
  • Lab Director: HARISEHENO RALIBENJA
  • NPI Number: 1003106774
  • Taxonomy: 251E00000X - Home Health

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CLIA Record

Field Name Field Value
CLIA Number 15D2018156
LAB Type Home Health Agency
Facility Name LOVING CARE AGENCY, INC D/B/A AVEANNA HEALTHCARE
Street 111 EAST LUDWIG ROAD, SUITE 109
City FORT WAYNE
State IN
ZIP 46825
Phone 260 969-0100
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 12/27/2024
Certificate Expiration Date 12/26/2026
Facility Type Home Health Agency
Lab Director HARISEHENO RALIBENJA

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