15D1042092 CLIA NUMBER - COMMUNITY CARE NETWORK

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Laboratory Demographics

CLIA Number: 15D1042092

Facility Name: COMMUNITY CARE NETWORK

Facility Address:
9235 BROADWAY
MERRILLVILLE, IN
ZIP 46410
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Facility Phone Number: 219 738-3550

Facility Type: Physician Office

Certificate Type: Microscopy

NPI Number: 1720400088

Taxonomy: 261QP2300X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	15D1042092
LAB Type	Physician Office
Facility Name	COMMUNITY CARE NETWORK
Street	9235 BROADWAY
City	MERRILLVILLE
State	IN
ZIP	46410
Phone	219 738-3550
CertificateType	3
CertificateEffectiveDate	6/20/2023
CertificateExpirationDate	6/19/2025
FacilityType	PPMP

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This page was last updated on: 4/23/2024