15D0355872 CLIA NUMBER - PORTER PHYSICIAN SERVICES, LLC

Laboratory Demographics

  • CLIA Code: 15D0355872
  • Facility Name: PORTER PHYSICIAN SERVICES, LLC
  • Facility Address: 650 DICKINSON RD STE A
    CHESTERTON, IN
    ZIP 46304
  • Facility Phone: 219 926-2133
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: DR. PATRICK FLEMING
  • NPI Number: 1508075680
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 15D0355872
LAB Type Pharmacy
Facility Name PORTER PHYSICIAN SERVICES, LLC
Street 650 DICKINSON RD STE A
City CHESTERTON
State IN
ZIP 46304
Phone 219 926-2133
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 12/23/2023
Certificate Expiration Date 12/22/2025
Facility Type Pharmacy
Lab Director DR. PATRICK FLEMING

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