15D2141614 CLIA NUMBER - FALL CREEK DIALYSIS

Laboratory Demographics

  • CLIA Code: 15D2141614
  • Facility Name: FALL CREEK DIALYSIS
  • Facility Address: 3820 N COLLEGE AVE
    INDIANAPOLIS, IN
    ZIP 46205
  • Facility Phone: 317 926-5125
  • Facility Type: End Stage Renal Disease Dialysis Facility
  • Facility Type: Waiver
  • Lab Director: JACQUELYNN T. SWAN
  • NPI Number: 1194238501
  • Taxonomy: 261QE0700X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 15D2141614
LAB Type End Stage Renal Disease Dialysis Facility
Facility Name FALL CREEK DIALYSIS
Street 3820 N COLLEGE AVE
City INDIANAPOLIS
State IN
ZIP 46205
Phone 317 926-5125
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 12/18/2023
Certificate Expiration Date 12/17/2025
Facility Type End Stage Renal Disease Dialysis Facility
Lab Director JACQUELYNN T. SWAN

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