15D2316514 CLIA NUMBER - SUMMIT BHC FT WAYNE, LLC D/B/A NORTHERN PATH RECOVERY CENTER

Laboratory Demographics

  • CLIA Code: 15D2316514
  • Facility Name: SUMMIT BHC FT WAYNE, LLC D/B/A NORTHERN PATH RECOVERY CENTER
  • Facility Address: 3110 EAST COLISEUM BOULEVARD
    FORT WAYNE, IN
    ZIP 46805
  • Facility Phone: 260 901-6980
  • Facility Type: Other - ADDICTION TREATMENT SERVI
  • Facility Type: Waiver
  • Lab Director: NATALIE WILLIAMS
  • NPI Number: 1003635418
  • Taxonomy: 324500000X - Substance Abuse Rehabilitation Facility

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CLIA Record

Field Name Field Value
CLIA Number 15D2316514
LAB Type Other - ADDICTION TREATMENT SERVI
Facility Name SUMMIT BHC FT WAYNE, LLC D/B/A NORTHERN PATH RECOVERY CENTER
Street 3110 EAST COLISEUM BOULEVARD
City FORT WAYNE
State IN
ZIP 46805
Phone 260 901-6980
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 1/7/2025
Certificate Expiration Date 1/6/2027
Facility Type Other - ADDICTION TREATMENT SERVI
Lab Director NATALIE WILLIAMS

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