15D0701130 CLIA NUMBER - PURDUE UNIVERSITY STUDENT HEALTH

Laboratory Demographics

  • CLIA Code: 15D0701130
  • Facility Name: PURDUE UNIVERSITY STUDENT HEALTH
  • Facility Address: 601 STADIUM MALL DR
    WEST LAFAYETTE, IN
    ZIP 47907
  • Facility Phone: (765) 494-1720
  • Facility Type: School/Student Health Service
  • Facility Type: Microscopy
  • Lab Director: DAVID A. GAY
  • NPI Number: 1053512004
  • Taxonomy: 122300000X - Dentist

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CLIA Record

Field Name Field Value
CLIA Number 15D0701130
LAB Type School/Student Health Service
Facility Name PURDUE UNIVERSITY STUDENT HEALTH
Street 601 STADIUM MALL DR
City WEST LAFAYETTE
State IN
ZIP 47907
Phone 7654941720
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 10/30/2025
Certificate Expiration Date 10/29/2027
Facility Type School/Student Health Service
Lab Director DAVID A. GAY

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