15D2263637 CLIA NUMBER - PARKVIEW ADVANTAGE CLINIC

Laboratory Demographics

  • CLIA Code: 15D2263637
  • Facility Name: PARKVIEW ADVANTAGE CLINIC
  • Facility Address: 4402 E STATE BLVD
    FORT WAYNE, IN
    ZIP 46805
  • Facility Phone: 260 266-0234
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: CAROL GARREAN
  • NPI Number: 1487662961
  • Taxonomy: 273R00000X - Psychiatric Unit

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CLIA Record

Field Name Field Value
CLIA Number 15D2263637
LAB Type Physician Office
Facility Name PARKVIEW ADVANTAGE CLINIC
Street 4402 E STATE BLVD
City FORT WAYNE
State IN
ZIP 46805
Phone 260 266-0234
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 6/30/2024
Certificate Expiration Date 6/29/2026
Facility Type Physician Office
Lab Director CAROL GARREAN

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