15D2046602 CLIA NUMBER - ORTHOPEDIC HOSPITAL - HOPD, THE

Laboratory Demographics

  • CLIA Code: 15D2046602
  • Facility Name: ORTHOPEDIC HOSPITAL - HOPD, THE
  • Facility Address: 7601 W JEFFERSON BLVD
    FORT WAYNE, IN
    ZIP 46804
  • Facility Phone: 260 435-2999
  • Facility Type: Hospital
  • Facility Type: Waiver
  • Lab Director: MARIELLE BLAUVELT
  • NPI Number: 1831771724
  • Taxonomy: 225X00000X - Occupational Therapist

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CLIA Record

Field Name Field Value
CLIA Number 15D2046602
LAB Type Hospital
Facility Name ORTHOPEDIC HOSPITAL - HOPD, THE
Street 7601 W JEFFERSON BLVD
City FORT WAYNE
State IN
ZIP 46804
Phone 260 435-2999
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/7/2024
Certificate Expiration Date 9/6/2026
Facility Type Hospital
Lab Director MARIELLE BLAUVELT

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