15D0355755 CLIA NUMBER - CHARLES F MOTLEY MD

Laboratory Demographics

  • CLIA Code: 15D0355755
  • Facility Name: CHARLES F MOTLEY MD
  • Facility Address: 6916 W JOHNSON RD
    LA PORTE, IN
    ZIP 46350
  • Facility Phone: 219 872-7247
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: DR. CHARLES F. MOTLEY
  • NPI Number: 1316948789
  • Taxonomy: 207R00000X - Internal Medicine

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CLIA Record

Field Name Field Value
CLIA Number 15D0355755
LAB Type Physician Office
Facility Name CHARLES F MOTLEY MD
Street 6916 W JOHNSON RD
City LA PORTE
State IN
ZIP 46350
Phone 219 872-7247
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 Physician Office
Lab Director DR. CHARLES F. MOTLEY

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