15D2086302 CLIA NUMBER - RIVERCREST SPECIALTY HOSPITAL, LLC

Laboratory Demographics

  • CLIA Code: 15D2086302
  • Facility Name: RIVERCREST SPECIALTY HOSPITAL, LLC
  • Facility Address: 1625 E JEFFERSON BLVD
    MISHAWAKA, IN
    ZIP 46545
  • Facility Phone: 574 255-1400
  • Facility Type: Hospital
  • Facility Type: Waiver
  • Lab Director: DR. KASHIF JANJUA
  • NPI Number: 1255740189
  • Taxonomy: 283Q00000X - Psychiatric Hospital

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CLIA Record

Field Name Field Value
CLIA Number 15D2086302
LAB Type Hospital
Facility Name RIVERCREST SPECIALTY HOSPITAL, LLC
Street 1625 E JEFFERSON BLVD
City MISHAWAKA
State IN
ZIP 46545
Phone 574 255-1400
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/31/2024
Certificate Expiration Date 10/30/2026
Facility Type Hospital
Lab Director DR. KASHIF JANJUA

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