15D1037467 CLIA NUMBER - NORTHSIDE DERMATOLOGY LLC

Laboratory Demographics

  • CLIA Code: 15D1037467
  • Facility Name: NORTHSIDE DERMATOLOGY LLC
  • Facility Address: 9865 E 116TH ST STE 200
    FISHERS, IN
    ZIP 46037
  • Facility Phone: 317 849-6600
  • Facility Type: Physician Office
  • Facility Type: Microscopy
  • Lab Director: CHRISTINE A. KUHN
  • NPI Number: 1710951165
  • Taxonomy: 207N00000X - Dermatology

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CLIA Record

Field Name Field Value
CLIA Number 15D1037467
LAB Type Physician Office
Facility Name NORTHSIDE DERMATOLOGY LLC
Street 9865 E 116TH ST STE 200
City FISHERS
State IN
ZIP 46037
Phone 317 849-6600
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 2/24/2025
Certificate Expiration Date 2/23/2027
Facility Type Physician Office
Lab Director CHRISTINE A. KUHN

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