15D1014569 CLIA NUMBER - PULMONARY SPECIALISTS OF NW INDIANA

Laboratory Demographics

  • CLIA Code: 15D1014569
  • Facility Name: PULMONARY SPECIALISTS OF NW INDIANA
  • Facility Address: 7875 GRAND BLVD
    HOBART, IN
    ZIP 46342
  • Facility Phone: 219 942-9658
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: RAJA G. DEVANATHAN
  • NPI Number: 1760601389
  • Taxonomy: 174400000X - Specialist

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CLIA Record

Field Name Field Value
CLIA Number 15D1014569
LAB Type Physician Office
Facility Name PULMONARY SPECIALISTS OF NW INDIANA
Street 7875 GRAND BLVD
City HOBART
State IN
ZIP 46342
Phone 219 942-9658
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 7/9/2023
Certificate Expiration Date 7/8/2025
Facility Type Physician Office
Lab Director RAJA G. DEVANATHAN

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This page was last updated on: 6/4/2025