15D2131776 CLIA NUMBER - 1717 SENIOR LIVING, LLC

Laboratory Demographics

  • CLIA Code: 15D2131776
  • Facility Name: 1717 SENIOR LIVING, LLC
  • Facility Address: 1703 W 86TH STREET
    INDIANAPOLIS, IN
    ZIP 46260
  • Facility Phone: 317 876-2916
  • Facility Type: Assisted Living Facility
  • Facility Type: Waiver
  • Lab Director: SHELLY D. MCFALL
  • NPI Number: 1609392422
  • Taxonomy: 310400000X - Assisted Living Facility

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CLIA Record

Field Name Field Value
CLIA Number 15D2131776
LAB Type Assisted Living Facility
Facility Name 1717 SENIOR LIVING, LLC
Street 1703 W 86TH STREET
City INDIANAPOLIS
State IN
ZIP 46260
Phone 317 876-2916
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 6/6/2025
Certificate Expiration Date 6/5/2027
Facility Type Assisted Living Facility
Lab Director SHELLY D. MCFALL

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