15D2275405 CLIA NUMBER - CARDINAL RECOVERY LLC

Laboratory Demographics

  • CLIA Code: 15D2275405
  • Facility Name: CARDINAL RECOVERY LLC
  • Facility Address: 3606 E JEFFERSON BLVD
    SOUTH BEND, IN
    ZIP 46615
  • Facility Phone: 574 544-0304
  • Facility Type: Other - SUBSTANCE USE TREATMENT F
  • Facility Type: Waiver
  • Lab Director: SHELBY MACLEOD
  • NPI Number: 1710632724
  • Taxonomy: 324500000X - Substance Abuse Rehabilitation Facility

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CLIA Record

Field Name Field Value
CLIA Number 15D2275405
LAB Type Other - SUBSTANCE USE TREATMENT F
Facility Name CARDINAL RECOVERY LLC
Street 3606 E JEFFERSON BLVD
City SOUTH BEND
State IN
ZIP 46615
Phone 574 544-0304
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 1/20/2025
Certificate Expiration Date 1/19/2027
Facility Type Other - SUBSTANCE USE TREATMENT F
Lab Director SHELBY MACLEOD

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