15D2110202 CLIA NUMBER - ADVANCED CARE CONNECTIONS LLC

Laboratory Demographics

  • CLIA Code: 15D2110202
  • Facility Name: ADVANCED CARE CONNECTIONS LLC
  • Facility Address: 3010 INDEPENDENCE DR
    FORT WAYNE, IN
    ZIP 46808
  • Facility Phone: 260 739-5821
  • Facility Type: Other - HOUSE CALL PRACTICE
  • Facility Type: Waiver
  • Lab Director: NIKKI J. MANN
  • NPI Number: 1780059790
  • Taxonomy: 261QP2300X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 15D2110202
LAB Type Other - HOUSE CALL PRACTICE
Facility Name ADVANCED CARE CONNECTIONS LLC
Street 3010 INDEPENDENCE DR
City FORT WAYNE
State IN
ZIP 46808
Phone 260 739-5821
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/10/2024
Certificate Expiration Date 3/9/2026
Facility Type Other - HOUSE CALL PRACTICE
Lab Director NIKKI J. MANN

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