15D0939171 CLIA NUMBER - FRANCISCAN PHY NETWORK-CGFM

Laboratory Demographics

  • CLIA Code: 15D0939171
  • Facility Name: FRANCISCAN PHY NETWORK-CGFM
  • Facility Address: 1703 W STONES CROSSING ROAD SUITE 200
    GREENWOOD, IN
    ZIP 46143
  • Facility Phone: 317 859-3737
  • Facility Type: Physician Office
  • Facility Type: Microscopy
  • Lab Director: DR. TIMOTHY J. NUSSBAUM
  • NPI Number: 1316310535
  • Taxonomy: 207RP1001X - Internal Medicine

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CLIA Record

Field Name Field Value
CLIA Number 15D0939171
LAB Type Physician Office
Facility Name FRANCISCAN PHY NETWORK-CGFM
Street 1703 W STONES CROSSING ROAD SUITE 200
City GREENWOOD
State IN
ZIP 46143
Phone 317 859-3737
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 1/21/2024
Certificate Expiration Date 1/20/2026
Facility Type Physician Office
Lab Director DR. TIMOTHY J. NUSSBAUM

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