15D2036813 CLIA NUMBER - FIVE STAR HOME HEALTH OF LAFAYETTE

Laboratory Demographics

  • CLIA Code: 15D2036813
  • Facility Name: FIVE STAR HOME HEALTH OF LAFAYETTE
  • Facility Address: 250 SHENANDOAH DR
    LAFAYETTE, IN
    ZIP 47905
  • Facility Phone: 765 449-4475
  • Facility Type: Home Health Agency
  • Facility Type: Waiver
  • Lab Director: ASHTYN L. KOCH
  • NPI Number: 1437224029
  • Taxonomy: 310400000X - Assisted Living Facility

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CLIA Record

Field Name Field Value
CLIA Number 15D2036813
LAB Type Home Health Agency
Facility Name FIVE STAR HOME HEALTH OF LAFAYETTE
Street 250 SHENANDOAH DR
City LAFAYETTE
State IN
ZIP 47905
Phone 765 449-4475
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 2/14/2024
Certificate Expiration Date 2/13/2026
Facility Type Home Health Agency
Lab Director ASHTYN L. KOCH

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