15D0905067 CLIA NUMBER - LA PORTE CLINIC COMPANY, LLC D/B/A NORTHWEST MEDICAL GROUP - LA PORTE

Laboratory Demographics

  • CLIA Code: 15D0905067
  • Facility Name: LA PORTE CLINIC COMPANY, LLC D/B/A NORTHWEST MEDICAL GROUP - LA PORTE
  • Facility Address: 8988 E HWY 20
    NEW CARLISLE, IN
    ZIP 46552
  • Facility Phone: 574 654-7779
  • Facility Type: Physician Office
  • Facility Type: Microscopy
  • Lab Director: LAURA HANNON
  • NPI Number: 1336250737
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 15D0905067
LAB Type Physician Office
Facility Name LA PORTE CLINIC COMPANY, LLC D/B/A NORTHWEST MEDICAL GROUP - LA PORTE
Street 8988 E HWY 20
City NEW CARLISLE
State IN
ZIP 46552
Phone 574 654-7779
Certificate Type Certificate for Provider-Performed Microscopy Procedures (PPMP)
Certificate Type Description This certificate is issued to a laboratory in which a physician, midlevel practitioner or dentist performs no tests other than the microscopy procedures. This certificate permits the laboratory to also perform waived tests.
Certificate Effective Date 8/25/2025
Certificate Expiration Date 8/24/2027
Facility Type Physician Office
Lab Director LAURA HANNON

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