15D0725690 CLIA NUMBER - MICHIANA BEHAVIORAL HEALTH CENTER

Laboratory Demographics

  • CLIA Code: 15D0725690
  • Facility Name: MICHIANA BEHAVIORAL HEALTH CENTER
  • Facility Address: 1800 N OAK DRIVE
    PLYMOUTH, IN
    ZIP 46563
  • Facility Phone: 574 936-3784
  • Facility Type: Hospital
  • Facility Type: Waiver
  • Lab Director: ROBERT RASTER
  • NPI Number: 1801822440
  • Taxonomy: 283Q00000X - Psychiatric Hospital

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 15D0725690
LAB Type Hospital
Facility Name MICHIANA BEHAVIORAL HEALTH CENTER
Street 1800 N OAK DRIVE
City PLYMOUTH
State IN
ZIP 46563
Phone 574 936-3784
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 Hospital
Lab Director ROBERT RASTER

Download Record

Download this CLIA record record in Text format: Export

Download this CLIA record record in Excel (CSV) format: Export

Download this CLIA record record in XML format: Export

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