Healther Providers Data Logo

15D0866486 CLIA NUMBER - ASCENSION MEDICAL GROUP ST VINCENT - PEYTON MANNING CHILDREN'S INDIANAPOLIS PEDIATRICS

Laboratory Demographics

CLIA Number: 15D0866486

Facility Name: ASCENSION MEDICAL GROUP ST VINCENT - PEYTON MANNING CHILDREN'S INDIANAPOLIS PEDIATRICS

Facility Address:
8424 NAAB RD, SUITE 3L
INDIANAPOLIS, IN
ZIP 46260
Get Directions

Facility Phone Number: 317 879-9777

Facility Type: Physician Office

Certificate Type: Waiver
NPI Number: 1003582602

Taxonomy: 332B00000X - Durable Medical Equipment & Medical Supplies
A supplier of medical equipment such as respirators, wheelchairs, home dialysis systems, or monitoring systems, that are prescribed by a physician for a patient's use in the home and that are usable for an extended period of time.

CLIA Record

Field Name Field Value
CLIA Number 15D0866486
LAB Type Physician Office
Facility Name ASCENSION MEDICAL GROUP ST VINCENT - PEYTON MANNING CHILDREN'S INDIANAPOLIS PEDIATRICS
Street 8424 NAAB RD, SUITE 3L
City INDIANAPOLIS
State IN
ZIP 46260
Phone 317 879-9777
CertificateType 4
CertificateEffectiveDate 9/1/2022
CertificateExpirationDate 8/31/2024
FacilityType Waiver

Download Record

Download this CLIA NUMBER record in Text format: Export

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

Download this CLIA NUMBER record in XML format: Export

This page was last updated on: 4/23/2024