15D1019268 CLIA NUMBER - LIBERTY LABORATORY INC

Laboratory Demographics

  • CLIA Code: 15D1019268
  • Facility Name: LIBERTY LABORATORY INC
  • Facility Address: 9301 CONNECTICUT DRIVE PINNACLE HOSPITAL
    CROWN POINT, IN
    ZIP 46307
  • Facility Phone: 708 488-1000
  • Facility Type: Independent
  • Facility Type: Waiver
  • Lab Director: PRAVIN H. PATEL
  • NPI Number: 1407298243
  • Taxonomy: 291U00000X - Clinical Medical Laboratory

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CLIA Record

Field Name Field Value
CLIA Number 15D1019268
LAB Type Independent
Facility Name LIBERTY LABORATORY INC
Street 9301 CONNECTICUT DRIVE PINNACLE HOSPITAL
City CROWN POINT
State IN
ZIP 46307
Phone 708 488-1000
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 7/11/2025
Certificate Expiration Date 7/10/2027
Facility Type Independent
Lab Director PRAVIN H. PATEL

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