15D1001261 CLIA NUMBER - PUTNAM PEDIATRICS & INTERNAL MEDICINE

Laboratory Demographics

  • CLIA Code: 15D1001261
  • Facility Name: PUTNAM PEDIATRICS & INTERNAL MEDICINE
  • Facility Address: 1542 S BLOOMINGTON ST STE 1300
    GREENCASTLE, IN
    ZIP 46135
  • Facility Phone: 765 301-7400
  • Facility Type: Rural Health Clinic
  • Facility Type: Microscopy
  • Lab Director: DR. LISA L. MARTIN
  • NPI Number: 1699833129
  • Taxonomy: 261QR1300X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 15D1001261
LAB Type Rural Health Clinic
Facility Name PUTNAM PEDIATRICS & INTERNAL MEDICINE
Street 1542 S BLOOMINGTON ST STE 1300
City GREENCASTLE
State IN
ZIP 46135
Phone 765 301-7400
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 7/5/2024
Certificate Expiration Date 7/4/2026
Facility Type Rural Health Clinic
Lab Director DR. LISA L. MARTIN

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