15D2186438 CLIA NUMBER - EV FW LIMITED PARTNERSHIP

Laboratory Demographics

  • CLIA Code: 15D2186438
  • Facility Name: EV FW LIMITED PARTNERSHIP
  • Facility Address: 12523 AUBURN ROAD
    FORT WAYNE, IN
    ZIP 46845
  • Facility Phone: 260 637-2830
  • Facility Type: Assisted Living Facility
  • Facility Type: Waiver
  • Lab Director: CHRISTINE CUMMINS
  • NPI Number: 1194358119
  • Taxonomy: 310400000X - Assisted Living Facility

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CLIA Record

Field Name Field Value
CLIA Number 15D2186438
LAB Type Assisted Living Facility
Facility Name EV FW LIMITED PARTNERSHIP
Street 12523 AUBURN ROAD
City FORT WAYNE
State IN
ZIP 46845
Phone 260 637-2830
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 6/17/2024
Certificate Expiration Date 6/16/2026
Facility Type Assisted Living Facility
Lab Director CHRISTINE CUMMINS

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This page was last updated on: 3/20/2025