15D0356490 CLIA NUMBER - COMMUNITY FAMILY PHYSICIANS PC/ JOHN R LARSON MD

Laboratory Demographics

  • CLIA Code: 15D0356490
  • Facility Name: COMMUNITY FAMILY PHYSICIANS PC/ JOHN R LARSON MD
  • Facility Address: 1724 W PLYMOUTH ST
    BREMEN, IN
    ZIP 46506
  • Facility Phone: 574 546-3045
  • Facility Type: Physician Office
  • Facility Type: Microscopy
  • Lab Director: PAUL R. GETTINGER
  • NPI Number: 1033326814
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 15D0356490
LAB Type Physician Office
Facility Name COMMUNITY FAMILY PHYSICIANS PC/ JOHN R LARSON MD
Street 1724 W PLYMOUTH ST
City BREMEN
State IN
ZIP 46506
Phone 574 546-3045
Certificate Type Certificate for Provider-Performed Microscopy Procedures (PPMP)
Certificate Type Description This certificate is issued to a laboratory in which a physician, midlevel practitioner or dentist performs no tests other than the microscopy procedures. This certificate permits the laboratory to also perform waived tests.
Certificate Effective Date 9/1/2024
Certificate Expiration Date 8/31/2026
Facility Type Physician Office
Lab Director PAUL R. GETTINGER

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