15D0988553 CLIA NUMBER - KURT A WIESE MD

Laboratory Demographics

  • CLIA Code: 15D0988553
  • Facility Name: KURT A WIESE MD
  • Facility Address: 401 WALL ST STE B
    VALPARAISO, IN
    ZIP 46383
  • Facility Phone: 219 462-7773
  • Facility Type: Physician Office
  • Facility Type: Microscopy
  • Lab Director: KURT A. WIESE
  • NPI Number: 1659470250
  • Taxonomy: 207V00000X - Obstetrics & Gynecology

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CLIA Record

Field Name Field Value
CLIA Number 15D0988553
LAB Type Physician Office
Facility Name KURT A WIESE MD
Street 401 WALL ST STE B
City VALPARAISO
State IN
ZIP 46383
Phone 219 462-7773
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 6/29/2025
Certificate Expiration Date 6/28/2027
Facility Type Physician Office
Lab Director KURT A. WIESE

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