15D0359964 CLIA NUMBER - JOHN C PETERSON MD

Laboratory Demographics

  • CLIA Code: 15D0359964
  • Facility Name: JOHN C PETERSON MD
  • Facility Address: 2423 W JACKSON ST
    MUNCIE, IN
    ZIP 47303
  • Facility Phone: (765) 282-7475
  • Facility Type: Physician Office
  • Facility Type: Microscopy
  • Lab Director: JOHN C. PETERSON
  • NPI Number: 1508880642
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 15D0359964
LAB Type Physician Office
Facility Name JOHN C PETERSON MD
Street 2423 W JACKSON ST
City MUNCIE
State IN
ZIP 47303
Phone 7652827475
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 JOHN C. PETERSON

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This page was last updated on: 5/18/2026