15D1080268 CLIA NUMBER - ADVANCED MEDICAL IMAGING

Laboratory Demographics

  • CLIA Code: 15D1080268
  • Facility Name: ADVANCED MEDICAL IMAGING
  • Facility Address: 2008 W BOULEVARD
    KOKOMO, IN
    ZIP 46902
  • Facility Phone: 765 454-9729
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: PETER SIMMONS
  • NPI Number: 1518965029
  • Taxonomy: 261QR0200X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 15D1080268
LAB Type Physician Office
Facility Name ADVANCED MEDICAL IMAGING
Street 2008 W BOULEVARD
City KOKOMO
State IN
ZIP 46902
Phone 765 454-9729
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 2/19/2024
Certificate Expiration Date 2/18/2026
Facility Type Physician Office
Lab Director PETER SIMMONS

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