15D1008013 CLIA NUMBER - INDIANA UNIVERSITY, HEALTH, INC

Laboratory Demographics

  • CLIA Code: 15D1008013
  • Facility Name: INDIANA UNIVERSITY, HEALTH, INC
  • Facility Address: 7411 HOPE DR
    FORT WAYNE, IN
    ZIP 46815
  • Facility Phone: 260 460-3214
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: AJAY S. GUPTA
  • NPI Number: 1689185886
  • Taxonomy: 1223P0221X - Dentist

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CLIA Record

Field Name Field Value
CLIA Number 15D1008013
LAB Type Physician Office
Facility Name INDIANA UNIVERSITY, HEALTH, INC
Street 7411 HOPE DR
City FORT WAYNE
State IN
ZIP 46815
Phone 260 460-3214
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/7/2025
Certificate Expiration Date 4/6/2027
Facility Type Physician Office
Lab Director AJAY S. GUPTA

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