15D0355665 CLIA NUMBER - LA PORTE CLINIC COMPANY, LLC D/B/A NORTHWEST MEDICAL GROUP - LA PORTE

Laboratory Demographics

  • CLIA Code: 15D0355665
  • Facility Name: LA PORTE CLINIC COMPANY, LLC D/B/A NORTHWEST MEDICAL GROUP - LA PORTE
  • Facility Address: 1509 STATE ST
    LA PORTE, IN
    ZIP 46350
  • Facility Phone: 219 326-5700
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: ASHLEY KIRKWOOD
  • NPI Number: 1205930385
  • Taxonomy: 207V00000X - Obstetrics & Gynecology

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 15D0355665
LAB Type Physician Office
Facility Name LA PORTE CLINIC COMPANY, LLC D/B/A NORTHWEST MEDICAL GROUP - LA PORTE
Street 1509 STATE ST
City LA PORTE
State IN
ZIP 46350
Phone 219 326-5700
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 6/17/2024
Certificate Expiration Date 6/16/2026
Facility Type Physician Office
Lab Director ASHLEY KIRKWOOD

Download Record

Download this CLIA record record in Text format: Export

Download this CLIA record record in Excel (CSV) format: Export

Download this CLIA record record in XML format: Export

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