15D1029507 CLIA NUMBER - CLOWN PEDIATRICS PC

Laboratory Demographics

  • CLIA Code: 15D1029507
  • Facility Name: CLOWN PEDIATRICS PC
  • Facility Address: 401 CAMBY CT
    GREENWOOD, IN
    ZIP 46142
  • Facility Phone: 317 881-8737
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: DR. JEREMY W. ROSCOE
  • NPI Number: 1669674461
  • Taxonomy: 174400000X - Specialist

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CLIA Record

Field Name Field Value
CLIA Number 15D1029507
LAB Type Physician Office
Facility Name CLOWN PEDIATRICS PC
Street 401 CAMBY CT
City GREENWOOD
State IN
ZIP 46142
Phone 317 881-8737
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/18/2024
Certificate Expiration Date 8/17/2026
Facility Type Physician Office
Lab Director DR. JEREMY W. ROSCOE

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