15D0696169 CLIA NUMBER - RICHARD G INGRAM MD INC

Laboratory Demographics

  • CLIA Code: 15D0696169
  • Facility Name: RICHARD G INGRAM MD INC
  • Facility Address: 121 E HIGH ST
    MONTPELIER, IN
    ZIP 47359
  • Facility Phone: 317 728-2421
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: RICHARD G. INGRAM
  • NPI Number: 1598716433
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 15D0696169
LAB Type Physician Office
Facility Name RICHARD G INGRAM MD INC
Street 121 E HIGH ST
City MONTPELIER
State IN
ZIP 47359
Phone 317 728-2421
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/1/2024
Certificate Expiration Date 8/31/2026
Facility Type Physician Office
Lab Director RICHARD G. INGRAM

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