15D0692637 CLIA NUMBER - NORTHSIDE PEDIATRIC ASSOCIATION PC

Laboratory Demographics

  • CLIA Code: 15D0692637
  • Facility Name: NORTHSIDE PEDIATRIC ASSOCIATION PC
  • Facility Address: 4225 VICKERS DRIVE
    COLUMBUS, IN
    ZIP 47203
  • Facility Phone: 812 379-9524
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: LINDA B. GUSE
  • NPI Number: 1851515597
  • Taxonomy: 208000000X - Pediatrics

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CLIA Record

Field Name Field Value
CLIA Number 15D0692637
LAB Type Physician Office
Facility Name NORTHSIDE PEDIATRIC ASSOCIATION PC
Street 4225 VICKERS DRIVE
City COLUMBUS
State IN
ZIP 47203
Phone 812 379-9524
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 7/16/2025
Certificate Expiration Date 7/15/2027
Facility Type Physician Office
Lab Director LINDA B. GUSE

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