15D0929175 CLIA NUMBER - ADVANCED SURGERY CENTER LLC

Laboratory Demographics

  • CLIA Code: 15D0929175
  • Facility Name: ADVANCED SURGERY CENTER LLC
  • Facility Address: 1400 TEAL RD STE 7
    LAFAYETTE, IN
    ZIP 47905
  • Facility Phone: 317 841-2020
  • Facility Type: Ambulatory Surgery Center
  • Facility Type: Waiver
  • Lab Director: TOSHA CHAPMAN
  • NPI Number: 1912971326
  • Taxonomy: 261QA1903X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 15D0929175
LAB Type Ambulatory Surgery Center
Facility Name ADVANCED SURGERY CENTER LLC
Street 1400 TEAL RD STE 7
City LAFAYETTE
State IN
ZIP 47905
Phone 317 841-2020
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 6/6/2025
Certificate Expiration Date 6/5/2027
Facility Type Ambulatory Surgery Center
Lab Director TOSHA CHAPMAN

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