15D1041395 CLIA NUMBER - KIDS FIRST PEDIATRICS ON 30

Laboratory Demographics

  • CLIA Code: 15D1041395
  • Facility Name: KIDS FIRST PEDIATRICS ON 30
  • Facility Address: 1160 JOLIET ST STE 103
    DYER, IN
    ZIP 46311
  • Facility Phone: 219 322-8534
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: JACQUELINE M. CHANG-STROMAN
  • NPI Number: 1255487138
  • Taxonomy: 208000000X - Pediatrics

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 15D1041395
LAB Type Physician Office
Facility Name KIDS FIRST PEDIATRICS ON 30
Street 1160 JOLIET ST STE 103
City DYER
State IN
ZIP 46311
Phone 219 322-8534
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 6/1/2025
Certificate Expiration Date 5/31/2027
Facility Type Physician Office
Lab Director JACQUELINE M. CHANG-STROMAN

Download Record

Download this CLIA record record in Text format: Export

Download this CLIA record record in Excel (CSV) format: Export

Download this CLIA record record in XML format: Export

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