15D2162946 CLIA NUMBER - SILVER BIRCH OF FORT WAYNE

Laboratory Demographics

  • CLIA Code: 15D2162946
  • Facility Name: SILVER BIRCH OF FORT WAYNE
  • Facility Address: 7125 S HANNA ST
    FORT WAYNE, IN
    ZIP 46816
  • Facility Phone: 260 447-8811
  • Facility Type: Assisted Living Facility
  • Facility Type: Waiver
  • Lab Director: ANGELA K. OTIS
  • NPI Number: 1073006938
  • Taxonomy: 310400000X - Assisted Living Facility

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CLIA Record

Field Name Field Value
CLIA Number 15D2162946
LAB Type Assisted Living Facility
Facility Name SILVER BIRCH OF FORT WAYNE
Street 7125 S HANNA ST
City FORT WAYNE
State IN
ZIP 46816
Phone 260 447-8811
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/5/2025
Certificate Expiration Date 3/4/2027
Facility Type Assisted Living Facility
Lab Director ANGELA K. OTIS

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