15D1067408 CLIA NUMBER - COMMUNITY EAST OB/GYN

Laboratory Demographics

  • CLIA Code: 15D1067408
  • Facility Name: COMMUNITY EAST OB/GYN
  • Facility Address: 1400 N RITTER AVE SUITE 410
    INDIANAPOLIS, IN
    ZIP 46219
  • Facility Phone: 317 355-9220
  • Facility Type: Physician Office
  • Facility Type: Microscopy
  • Lab Director: JILL WILSON
  • NPI Number: 1457743809
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 15D1067408
LAB Type Physician Office
Facility Name COMMUNITY EAST OB/GYN
Street 1400 N RITTER AVE SUITE 410
City INDIANAPOLIS
State IN
ZIP 46219
Phone 317 355-9220
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 4/18/2025
Certificate Expiration Date 4/17/2027
Facility Type Physician Office
Lab Director JILL WILSON

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