15D1072133 CLIA NUMBER - MICHIANA INTERNAL MEDICINE, PC

Laboratory Demographics

  • CLIA Code: 15D1072133
  • Facility Name: MICHIANA INTERNAL MEDICINE, PC
  • Facility Address: 525 W BRISTOL STREET
    ELKHART, IN
    ZIP 46514
  • Facility Phone: 574 295-5900
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: ISRAR A. SIDDIQI
  • NPI Number: 1467571570
  • Taxonomy: 261QP2300X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 15D1072133
LAB Type Physician Office
Facility Name MICHIANA INTERNAL MEDICINE, PC
Street 525 W BRISTOL STREET
City ELKHART
State IN
ZIP 46514
Phone 574 295-5900
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/9/2025
Certificate Expiration Date 3/8/2027
Facility Type Physician Office
Lab Director ISRAR A. SIDDIQI

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