15D0880058 CLIA NUMBER - MERIDIAN PLASTIC SURGERY CENTER

Laboratory Demographics

  • CLIA Code: 15D0880058
  • Facility Name: MERIDIAN PLASTIC SURGERY CENTER
  • Facility Address: 170 W 106TH ST
    INDIANAPOLIS, IN
    ZIP 46290
  • Facility Phone: 317 575-0330
  • Facility Type: Ambulatory Surgery Center
  • Facility Type: Waiver
  • Lab Director: MARY P. HUSCROFT
  • NPI Number: 1831148527
  • Taxonomy: 261QA1903X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 15D0880058
LAB Type Ambulatory Surgery Center
Facility Name MERIDIAN PLASTIC SURGERY CENTER
Street 170 W 106TH ST
City INDIANAPOLIS
State IN
ZIP 46290
Phone 317 575-0330
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 12/7/2023
Certificate Expiration Date 12/6/2025
Facility Type Ambulatory Surgery Center
Lab Director MARY P. HUSCROFT

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