15D0923284 CLIA NUMBER - AMERICAN HEALTH NETWORK OF IN, LLC

Laboratory Demographics

CLIA Number: 15D0923284

Facility Name: AMERICAN HEALTH NETWORK OF IN, LLC

Facility Address:
3743 LANDMARK DR STE 200
LAFAYETTE, IN
ZIP 47905
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Facility Phone Number: 765 448-4511

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1578658423

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	15D0923284
LAB Type	Physician Office
Facility Name	AMERICAN HEALTH NETWORK OF IN, LLC
Street	3743 LANDMARK DR STE 200
City	LAFAYETTE
State	IN
ZIP	47905
Phone	765 448-4511
CertificateType	4
CertificateEffectiveDate	5/10/2024
CertificateExpirationDate	5/9/2026
FacilityType	Waiver

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