15D0355697 CLIA NUMBER - BEACON MED GRP CORE LAB

Laboratory Demographics

  • CLIA Code: 15D0355697
  • Facility Name: BEACON MED GRP CORE LAB
  • Facility Address: 900 I ST
    LA PORTE, IN
    ZIP 46350
  • Facility Phone: 219 324-1755
  • Facility Type: Physician Office
  • Facility Type: Accreditation
  • Lab Director: JENNIFER A. ALDERINK
  • NPI Number: 1639129117
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 15D0355697
LAB Type Physician Office
Facility Name BEACON MED GRP CORE LAB
Street 900 I ST
City LA PORTE
State IN
ZIP 46350
Phone 219 324-1755
Certificate Type Certificate of Accreditation
Certificate Type Description This is a certificate that is issued to a laboratory on the basis of the laboratory's accreditation by an accreditation organization approved by CMS.
Certificate Effective Date 6/24/2024
Certificate Expiration Date 6/23/2026
Facility Type Physician Office
Lab Director JENNIFER A. ALDERINK

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