15D0996282 CLIA NUMBER - MIRAVISTA DIAGNOSTICS, LLC

Laboratory Demographics

  • CLIA Code: 15D0996282
  • Facility Name: MIRAVISTA DIAGNOSTICS, LLC
  • Facility Address: 4705 DECATUR BLVD
    INDIANAPOLIS, IN
    ZIP 46241
  • Facility Phone: 317 856-2681
  • Facility Type: Independent
  • Facility Type: Accreditation
  • Lab Director: DR. LAUREN COOPER
  • NPI Number: 1588600456
  • Taxonomy: 291U00000X - Clinical Medical Laboratory

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 15D0996282
LAB Type Independent
Facility Name MIRAVISTA DIAGNOSTICS, LLC
Street 4705 DECATUR BLVD
City INDIANAPOLIS
State IN
ZIP 46241
Phone 317 856-2681
Certificate Type Certificate of Accreditation
Certificate Type Description This is a certificate that is issued to a laboratory on the basis of the laboratory's accreditation by an accreditation organization approved by CMS.
Certificate Effective Date 2/10/2024
Certificate Expiration Date 2/9/2026
Facility Type Independent
Lab Director DR. LAUREN COOPER

Download Record

Download this CLIA record record in Text format: Export

Download this CLIA record record in Excel (CSV) format: Export

Download this CLIA record record in XML format: Export

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