15D0356731 CLIA NUMBER - GRANGER COMMUNITY MEDICINE

Laboratory Demographics

  • CLIA Code: 15D0356731
  • Facility Name: GRANGER COMMUNITY MEDICINE
  • Facility Address: 12563 STATE RD 23
    GRANGER, IN
    ZIP 46530
  • Facility Phone: 574 335-8300
  • Facility Type: Physician Office
  • Facility Type: Microscopy
  • Lab Director: JASON J. RANSOM
  • NPI Number: 1881270270
  • Taxonomy: 1041C0700X - Social Worker

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 15D0356731
LAB Type Physician Office
Facility Name GRANGER COMMUNITY MEDICINE
Street 12563 STATE RD 23
City GRANGER
State IN
ZIP 46530
Phone 574 335-8300
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 3/17/2024
Certificate Expiration Date 3/16/2026
Facility Type Physician Office
Lab Director JASON J. RANSOM

Download Record

Download this CLIA record record in Text format: Export

Download this CLIA record record in Excel (CSV) format: Export

Download this CLIA record record in XML format: Export

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