15D2240358 CLIA NUMBER - ESSENTIAL LAB, LLC

Laboratory Demographics

  • CLIA Code: 15D2240358
  • Facility Name: ESSENTIAL LAB, LLC
  • Facility Address: 4656 W JEFFERSON BLVD SUITE 125
    FORT WAYNE, IN
    ZIP 46804
  • Facility Phone: (260) 467-9838
  • Facility Type: Independent
  • Facility Type: Waiver
  • Lab Director: SEDRICKA J. EPPERSON
  • NPI Number: 1063178127
  • Taxonomy: 261Q00000X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 15D2240358
LAB Type Independent
Facility Name ESSENTIAL LAB, LLC
Street 4656 W JEFFERSON BLVD SUITE 125
City FORT WAYNE
State IN
ZIP 46804
Phone 2604679838
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/19/2025
Certificate Expiration Date 10/18/2027
Facility Type Independent
Lab Director SEDRICKA J. EPPERSON

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This page was last updated on: 5/18/2026