15D0357414 CLIA NUMBER - SOUTH BEND CLINIC LABORATORY

Laboratory Demographics

  • CLIA Code: 15D0357414
  • Facility Name: SOUTH BEND CLINIC LABORATORY
  • Facility Address: 1945 LINCOLNWAY EAST
    SOUTH BEND, IN
    ZIP 46613
  • Facility Phone: 574 237-9222
  • Facility Type: Physician Office
  • Facility Type: Certificate of Compliance
  • Lab Director: NICOLE P. ANEST
  • NPI Number: 1568714202
  • Taxonomy: 261QE0700X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 15D0357414
LAB Type Physician Office
Facility Name SOUTH BEND CLINIC LABORATORY
Street 1945 LINCOLNWAY EAST
City SOUTH BEND
State IN
ZIP 46613
Phone 574 237-9222
Certificate Type Certificate of Compliance
Certificate Type Description This certificate is issued to a laboratory after an inspection that finds the laboratory to be in compliance with all applicable CLIA requirements.
Certificate Effective Date 5/13/2025
Certificate Expiration Date 5/12/2027
Facility Type Physician Office
Lab Director NICOLE P. ANEST

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