15D2124870 CLIA NUMBER - WICKSHIRE FORT HARRISON OPCO LLC

Laboratory Demographics

  • CLIA Code: 15D2124870
  • Facility Name: WICKSHIRE FORT HARRISON OPCO LLC
  • Facility Address: 8025 DOUBLEDAY DRIVE
    INDIANAPOLIS, IN
    ZIP 46216
  • Facility Phone: 615 942-0240
  • Facility Type: Assisted Living Facility
  • Facility Type: Waiver
  • Lab Director: SCOTT DEIG
  • NPI Number: 1982243382
  • Taxonomy: 310400000X - Assisted Living Facility

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CLIA Record

Field Name Field Value
CLIA Number 15D2124870
LAB Type Assisted Living Facility
Facility Name WICKSHIRE FORT HARRISON OPCO LLC
Street 8025 DOUBLEDAY DRIVE
City INDIANAPOLIS
State IN
ZIP 46216
Phone 615 942-0240
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 1/26/2025
Certificate Expiration Date 1/25/2027
Facility Type Assisted Living Facility
Lab Director SCOTT DEIG

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