15D1042265 CLIA NUMBER - COMMUNITY PHY OF IND, INC

Laboratory Demographics

  • CLIA Code: 15D1042265
  • Facility Name: COMMUNITY PHY OF IND, INC
  • Facility Address: 8890 E 116TH ST, STE 260
    FISHERS, IN
    ZIP 46038
  • Facility Phone: 317 585-7827
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: KRISTEN W. GOLLNICK
  • NPI Number: 1578129508
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 15D1042265
LAB Type Physician Office
Facility Name COMMUNITY PHY OF IND, INC
Street 8890 E 116TH ST, STE 260
City FISHERS
State IN
ZIP 46038
Phone 317 585-7827
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 6/23/2025
Certificate Expiration Date 6/22/2027
Facility Type Physician Office
Lab Director KRISTEN W. GOLLNICK

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