15D0983588 CLIA NUMBER - GEETHA SIVAM MD

Laboratory Demographics

  • CLIA Code: 15D0983588
  • Facility Name: GEETHA SIVAM MD
  • Facility Address: 9725 PRAIRIE AVE
    HIGHLAND, IN
    ZIP 46322
  • Facility Phone: 219 924-5300
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: GEETHA SIVAM
  • NPI Number: 1407802960
  • Taxonomy: 208000000X - Pediatrics

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CLIA Record

Field Name Field Value
CLIA Number 15D0983588
LAB Type Physician Office
Facility Name GEETHA SIVAM MD
Street 9725 PRAIRIE AVE
City HIGHLAND
State IN
ZIP 46322
Phone 219 924-5300
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 2/27/2025
Certificate Expiration Date 2/26/2027
Facility Type Physician Office
Lab Director GEETHA SIVAM

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