15D0927647 CLIA NUMBER - BEACON MEDICAL GRP-GOSHEN

Laboratory Demographics

CLIA Number: 15D0927647

Facility Name: BEACON MEDICAL GRP-GOSHEN

Facility Address:
2120 RIETH BLVD STE A
GOSHEN, IN
ZIP 46527
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Facility Phone Number: 574 875-5126

Facility Type: Physician Office

Certificate Type: Microscopy

NPI Number: 1306863915

Taxonomy: 207Q00000X - Family Medicine
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.

CLIA Record

Field Name	Field Value
CLIA Number	15D0927647
LAB Type	Physician Office
Facility Name	BEACON MEDICAL GRP-GOSHEN
Street	2120 RIETH BLVD STE A
City	GOSHEN
State	IN
ZIP	46527
Phone	574 875-5126
CertificateType	3
CertificateEffectiveDate	12/21/2022
CertificateExpirationDate	12/20/2024
FacilityType	PPMP

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