FIVE STAR RESIDENCES OF FORT WAYNE
NPI 1841365434
Assisted Living Facility in Fort Wayne, IN
About Five Star Residences Of Fort Wayne NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
FIVE STAR RESIDENCES OF FORT WAYNE (NPI 1841365434) is a healthcare organization registered as an assisted living facility in Fort Wayne, Indiana and active in the NPI registry since November 2006. The organization holds a CLIA Waiver certificate valid through May 22, 2028 and lists Katherine E Potter, President & Chief Executive Officer, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
A facility providing supportive services to individuals who can function independently in most areas of activity, but need assistance and/or monitoring to assure safety and well being.
Other Names 1
CLIA Information
The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:
- CLIA Number
- 15D2149009
- Facility Type
- Assisted Living Facility
- Certificate Effective Date
- May 23, 2026
- Certificate Expiration Date
- May 22, 2028
- Laboratory Director
- NIKKI ROGERS
- Certificate Type
- Certificate of Waiver
- Certificate Type Description
- This CLIA certificate is issued to Five Star Residences Of Fort Wayne to perform only waived tests. CLIA defines waived tests as simple tests with a low risk for an incorrect result. Waived tests include certain tests listed in CLIA regulations, tests cleared by the FDA for home use and tests approved by the FDA for waived status and that meet CLIA waiver criteria.
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Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1841365434, enumerated as an "organization" on November 21, 2006.
The provider is located at 2601 COVINGTON COMMONS DRIVE FORT WAYNE, IN 46804 and the phone number is (260) 432-1932.
Assisted Living Facility with taxonomy code 310400000X.
