15D0711476 CLIA NUMBER - PULASKI MEMORIAL HOSPITAL D/B/A SOUTH SHORE HEALTH & REHABILITATI

Laboratory Demographics

  • CLIA Code: 15D0711476
  • Facility Name: PULASKI MEMORIAL HOSPITAL D/B/A SOUTH SHORE HEALTH & REHABILITATI
  • Facility Address: 353 TYLER STREET
    GARY, IN
    ZIP 46402
  • Facility Phone: 219 886-7070
  • Facility Type: Skilled Nursing Facility/Nursing Facility
  • Facility Type: Waiver
  • Lab Director: PHILIP M. BIRN
  • NPI Number: 1346292737
  • Taxonomy: 314000000X - Skilled Nursing Facility

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CLIA Record

Field Name Field Value
CLIA Number 15D0711476
LAB Type Skilled Nursing Facility/Nursing Facility
Facility Name PULASKI MEMORIAL HOSPITAL D/B/A SOUTH SHORE HEALTH & REHABILITATI
Street 353 TYLER STREET
City GARY
State IN
ZIP 46402
Phone 219 886-7070
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 Skilled Nursing Facility/Nursing Facility
Lab Director PHILIP M. BIRN

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