15D0679669 CLIA NUMBER - FRANCISCAN PHYSICIAN NETWORK - FTFM

Laboratory Demographics

CLIA Code: 15D0679669
Facility Name: FRANCISCAN PHYSICIAN NETWORK - FTFM
Facility Address: 8325 E SOUTHPORT RD STE 100
INDIANAPOLIS, IN
ZIP 46259
Facility Phone: 317 862-6609
Facility Type: Physician Office
Facility Type: Waiver
Lab Director: DR. CASS R. CORTEZ
NPI Number: 1114314606
Taxonomy: 251T00000X - Program of All-Inclusive Care for the Elderly (PACE) Provider Organization

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CLIA Record

Field Name	Field Value
CLIA Number	15D0679669
LAB Type	Physician Office
Facility Name	FRANCISCAN PHYSICIAN NETWORK - FTFM
Street	8325 E SOUTHPORT RD STE 100
City	INDIANAPOLIS
State	IN
ZIP	46259
Phone	317 862-6609
Certificate Type	Certificate of Waiver
Certificate Type Description	This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date	8/31/2024
Certificate Expiration Date	8/30/2026
Facility Type	Physician Office
Lab Director	DR. CASS R. CORTEZ

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