15D0355855 CLIA NUMBER - LA PORTE CLINIC COMPANY, LLC D/B/A NORTHWEST MEDICAL GROUP - LA PORTE

Laboratory Demographics

  • CLIA Code: 15D0355855
  • Facility Name: LA PORTE CLINIC COMPANY, LLC D/B/A NORTHWEST MEDICAL GROUP - LA PORTE
  • Facility Address: 701 W TALMER AVE
    NORTH JUDSON, IN
    ZIP 46366
  • Facility Phone: 574 896-5533
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: DR. THOMAS BROWNE
  • NPI Number: 1942466354
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 15D0355855
LAB Type Physician Office
Facility Name LA PORTE CLINIC COMPANY, LLC D/B/A NORTHWEST MEDICAL GROUP - LA PORTE
Street 701 W TALMER AVE
City NORTH JUDSON
State IN
ZIP 46366
Phone 574 896-5533
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. THOMAS BROWNE

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