15D0920328 CLIA NUMBER - RAPHAEL HEALTH CENTER

Laboratory Demographics

  • CLIA Code: 15D0920328
  • Facility Name: RAPHAEL HEALTH CENTER
  • Facility Address: 401 E 34TH ST
    INDIANAPOLIS, IN
    ZIP 46205
  • Facility Phone: 317 926-1507
  • Facility Type: Federally Qualified Health Center
  • Facility Type: Microscopy
  • Lab Director: NATHAN V. ROTH
  • NPI Number: 1487764759
  • Taxonomy: 261QF0400X - Clinic/Center

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 15D0920328
LAB Type Federally Qualified Health Center
Facility Name RAPHAEL HEALTH CENTER
Street 401 E 34TH ST
City INDIANAPOLIS
State IN
ZIP 46205
Phone 317 926-1507
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 3/13/2024
Certificate Expiration Date 3/12/2026
Facility Type Federally Qualified Health Center
Lab Director NATHAN V. ROTH

Download Record

Download this CLIA record record in Text format: Export

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

Download this CLIA record record in XML format: Export

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