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15D0989673 CLIA NUMBER - PARKVIEW INTERNAL MED & PEDIATRICS

Laboratory Demographics

CLIA Number: 15D0989673

Facility Name: PARKVIEW INTERNAL MED & PEDIATRICS

Facility Address:
11123 PARKVIEW PLAZA DR STE 106
FORT WAYNE, IN
ZIP 46845
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Facility Phone Number: 219 672-6550

Facility Type: Physician Office

Certificate Type: Waiver
NPI Number: 1477638260

Taxonomy: 207Q00000X - Family Medicine
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.

CLIA Record

Field Name Field Value
CLIA Number 15D0989673
LAB Type Physician Office
Facility Name PARKVIEW INTERNAL MED & PEDIATRICS
Street 11123 PARKVIEW PLAZA DR STE 106
City FORT WAYNE
State IN
ZIP 46845
Phone 219 672-6550
CertificateType 4
CertificateEffectiveDate 12/19/2023
CertificateExpirationDate 12/18/2025
FacilityType Waiver

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This page was last updated on: 4/23/2024