15D1058657 CLIA NUMBER - LIZTON FAMILY MEDICINE

Laboratory Demographics

  • CLIA Code: 15D1058657
  • Facility Name: LIZTON FAMILY MEDICINE
  • Facility Address: 1045 WYATT WAY
    LIZTON, IN
    ZIP 46149
  • Facility Phone: 317 994-6600
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: DAVID M. STOPPERICH
  • NPI Number: 1710084025
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 15D1058657
LAB Type Physician Office
Facility Name LIZTON FAMILY MEDICINE
Street 1045 WYATT WAY
City LIZTON
State IN
ZIP 46149
Phone 317 994-6600
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 1/1/2025
Certificate Expiration Date 12/31/2026
Facility Type Physician Office
Lab Director DAVID M. STOPPERICH

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