15D0857127 CLIA NUMBER - METHODIST PHY GRP-ANEKWE/BROADWAY

Laboratory Demographics

  • CLIA Code: 15D0857127
  • Facility Name: METHODIST PHY GRP-ANEKWE/BROADWAY
  • Facility Address: 650 GRANT ST, SUITE #7
    GARY, IN
    ZIP 46404
  • Facility Phone: 219 887-0900
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: ADOLPHUS A. ANEKWE
  • NPI Number: 1720290349
  • Taxonomy: 207R00000X - Internal Medicine

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CLIA Record

Field Name Field Value
CLIA Number 15D0857127
LAB Type Physician Office
Facility Name METHODIST PHY GRP-ANEKWE/BROADWAY
Street 650 GRANT ST, SUITE #7
City GARY
State IN
ZIP 46404
Phone 219 887-0900
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 ADOLPHUS A. ANEKWE

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