15D0669575 CLIA NUMBER - KENDALLVILLE MANOR HEALTHCARE CENTER

Laboratory Demographics

  • CLIA Code: 15D0669575
  • Facility Name: KENDALLVILLE MANOR HEALTHCARE CENTER
  • Facility Address: 1802 DOWLING ST
    KENDALLVILLE, IN
    ZIP 46755
  • Facility Phone: 219 347-4374
  • Facility Type: Skilled Nursing Facility/Nursing Facility
  • Facility Type: Waiver
  • Lab Director: CHRISTOPHER P. FRAZIER
  • NPI Number: 1629143805
  • Taxonomy: 111N00000X - Chiropractor

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CLIA Record

Field Name Field Value
CLIA Number 15D0669575
LAB Type Skilled Nursing Facility/Nursing Facility
Facility Name KENDALLVILLE MANOR HEALTHCARE CENTER
Street 1802 DOWLING ST
City KENDALLVILLE
State IN
ZIP 46755
Phone 219 347-4374
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/1/2024
Certificate Expiration Date 8/31/2026
Facility Type Skilled Nursing Facility/Nursing Facility
Lab Director CHRISTOPHER P. FRAZIER

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This page was last updated on: 6/4/2025