15D1033532 CLIA NUMBER - LA PORTE CLINIC COMPANY, LLC D/B/A NORTHWEST MEDICAL GROUP - LA PORTE

Laboratory Demographics

  • CLIA Code: 15D1033532
  • Facility Name: LA PORTE CLINIC COMPANY, LLC D/B/A NORTHWEST MEDICAL GROUP - LA PORTE
  • Facility Address: 3777 N FRONTAGE ROAD, STE 600
    MICHIGAN CITY, IN
    ZIP 46360
  • Facility Phone: 219 879-6262
  • Facility Type: Physician Office
  • Facility Type: Microscopy
  • Lab Director: JULIUS ELLIS
  • NPI Number: 1851593099
  • Taxonomy: 207V00000X - Obstetrics & Gynecology

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CLIA Record

Field Name Field Value
CLIA Number 15D1033532
LAB Type Physician Office
Facility Name LA PORTE CLINIC COMPANY, LLC D/B/A NORTHWEST MEDICAL GROUP - LA PORTE
Street 3777 N FRONTAGE ROAD, STE 600
City MICHIGAN CITY
State IN
ZIP 46360
Phone 219 879-6262
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 3/1/2024
Certificate Expiration Date 2/28/2026
Facility Type Physician Office
Lab Director JULIUS ELLIS

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