15D0930100 CLIA NUMBER - JOHNSON MEMORIAL HEALTH PHYSICIAN NETWORK, LLC

Laboratory Demographics

  • CLIA Code: 15D0930100
  • Facility Name: JOHNSON MEMORIAL HEALTH PHYSICIAN NETWORK, LLC
  • Facility Address: 1155 W JEFFERSON ST SUITE 101
    FRANKLIN, IN
    ZIP 46131
  • Facility Phone: 317 736-6133
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: ROBERT D. KAVALMAN
  • NPI Number: 1629091061
  • Taxonomy: 314000000X - Skilled Nursing Facility

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CLIA Record

Field Name Field Value
CLIA Number 15D0930100
LAB Type Physician Office
Facility Name JOHNSON MEMORIAL HEALTH PHYSICIAN NETWORK, LLC
Street 1155 W JEFFERSON ST SUITE 101
City FRANKLIN
State IN
ZIP 46131
Phone 317 736-6133
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/14/2025
Certificate Expiration Date 3/13/2027
Facility Type Physician Office
Lab Director ROBERT D. KAVALMAN

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