15D1073235 CLIA NUMBER - CLI SURGERY CENTER

Laboratory Demographics

  • CLIA Code: 15D1073235
  • Facility Name: CLI SURGERY CENTER
  • Facility Address: 1601 W LINCOLN RD
    KOKOMO, IN
    ZIP 46904
  • Facility Phone: 765 453-5696
  • Facility Type: Ambulatory Surgery Center
  • Facility Type: Waiver
  • Lab Director: KUUMBA K. LONG
  • NPI Number: 1639386659
  • Taxonomy: 261QA1903X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 15D1073235
LAB Type Ambulatory Surgery Center
Facility Name CLI SURGERY CENTER
Street 1601 W LINCOLN RD
City KOKOMO
State IN
ZIP 46904
Phone 765 453-5696
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/5/2025
Certificate Expiration Date 9/4/2027
Facility Type Ambulatory Surgery Center
Lab Director KUUMBA K. LONG

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