15D0989138 CLIA NUMBER - NORTH PUTNAM FAMILY HEALTHCARE

Laboratory Demographics

  • CLIA Code: 15D0989138
  • Facility Name: NORTH PUTNAM FAMILY HEALTHCARE
  • Facility Address: 209 EAST PAT RADY WAY
    BAINBRIDGE, IN
    ZIP 46105
  • Facility Phone: 765 301-7679
  • Facility Type: Rural Health Clinic
  • Facility Type: Microscopy
  • Lab Director: CECILEY CASSELMAN
  • NPI Number: 1821208596
  • Taxonomy: 251300000X - Local Education Agency (LEA)

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CLIA Record

Field Name Field Value
CLIA Number 15D0989138
LAB Type Rural Health Clinic
Facility Name NORTH PUTNAM FAMILY HEALTHCARE
Street 209 EAST PAT RADY WAY
City BAINBRIDGE
State IN
ZIP 46105
Phone 765 301-7679
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 7/18/2025
Certificate Expiration Date 7/17/2027
Facility Type Rural Health Clinic
Lab Director CECILEY CASSELMAN

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