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15D2085543 CLIA NUMBER - HERITAGE OF FORT WAYNE, THE

Laboratory Demographics

CLIA Number: 15D2085543

Facility Name: HERITAGE OF FORT WAYNE, THE

Facility Address:
5250 HERITAGE PKWY
FORT WAYNE, IN
ZIP 46835
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Facility Phone Number: 260 209-6279

Facility Type: Ancillary Testing Site in Health Care Center

Certificate Type: Waiver
NPI Number: 1801205240

Taxonomy: 314000000X - Skilled Nursing Facility
(1) A skilled nursing facility is a facility or distinct part of an institution whose primary function is to provide medical, continuous nursing, and other health and social services to patients who are not in an acute phase of illness requiring services in a hospital, but who require primary restorative or skilled nursing services on an inpatient basis above the level of intermediate or custodial care in order to reach a degree of body functioning to permit self care in essential daily living. It meets any licensing or certification standards et forth by the jurisdiction where it is located. A skilled nursing facility may be a freestanding facility or part of a hospital that has been certified by Medicare to admit patients requiring subacute care and rehabilitation; (2) Provides non-acute medical and skilled nursing care services, therapy and social services under the supervision of a licensed registered nurse on a 24-hour basis.

CLIA Record

Field Name Field Value
CLIA Number 15D2085543
LAB Type Ancillary Testing Site in Health Care Center
Facility Name HERITAGE OF FORT WAYNE, THE
Street 5250 HERITAGE PKWY
City FORT WAYNE
State IN
ZIP 46835
Phone 260 209-6279
CertificateType 4
CertificateEffectiveDate 10/16/2022
CertificateExpirationDate 10/15/2024
FacilityType Waiver

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This page was last updated on: 4/23/2024