15D0861663 CLIA NUMBER - COMPREHENSIVE RENAL CARE - GARY

Laboratory Demographics

  • CLIA Code: 15D0861663
  • Facility Name: COMPREHENSIVE RENAL CARE - GARY
  • Facility Address: 4802 BROADWAY
    GARY, IN
    ZIP 46408
  • Facility Phone: 219 887-1199
  • Facility Type: End Stage Renal Disease Dialysis Facility
  • Facility Type: Waiver
  • Lab Director: RAIED ABDULLAH
  • NPI Number: 1952364648
  • Taxonomy: 261QE0700X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 15D0861663
LAB Type End Stage Renal Disease Dialysis Facility
Facility Name COMPREHENSIVE RENAL CARE - GARY
Street 4802 BROADWAY
City GARY
State IN
ZIP 46408
Phone 219 887-1199
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 2/2/2024
Certificate Expiration Date 2/1/2026
Facility Type End Stage Renal Disease Dialysis Facility
Lab Director RAIED ABDULLAH

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