15D1083939 CLIA NUMBER - PURPLE HEART PEDIATRICS

Laboratory Demographics

  • CLIA Code: 15D1083939
  • Facility Name: PURPLE HEART PEDIATRICS
  • Facility Address: 222 E LINCOLNWAY STE A
    LA PORTE, IN
    ZIP 46350
  • Facility Phone: 219 324-4499
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: ADAM CHRISTIE
  • NPI Number: 1780781963
  • Taxonomy: 208000000X - Pediatrics

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CLIA Record

Field Name Field Value
CLIA Number 15D1083939
LAB Type Physician Office
Facility Name PURPLE HEART PEDIATRICS
Street 222 E LINCOLNWAY STE A
City LA PORTE
State IN
ZIP 46350
Phone 219 324-4499
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 5/13/2024
Certificate Expiration Date 5/12/2026
Facility Type Physician Office
Lab Director ADAM CHRISTIE

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