15D1084504 CLIA NUMBER - JOSEPHSON WALLACK MUNSHOWER NEUR PC ATTN KRISTI MANN

Laboratory Demographics

  • CLIA Code: 15D1084504
  • Facility Name: JOSEPHSON WALLACK MUNSHOWER NEUR PC ATTN KRISTI MANN
  • Facility Address: 8051 S EMERSON AVE, STE 350
    INDIANAPOLIS, IN
    ZIP 46237
  • Facility Phone: 317 859-1020
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: CRAIG E. HERRMAN
  • NPI Number: 1669569729
  • Taxonomy: 2084N0400X - Psychiatry & Neurology

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CLIA Record

Field Name Field Value
CLIA Number 15D1084504
LAB Type Physician Office
Facility Name JOSEPHSON WALLACK MUNSHOWER NEUR PC ATTN KRISTI MANN
Street 8051 S EMERSON AVE, STE 350
City INDIANAPOLIS
State IN
ZIP 46237
Phone 317 859-1020
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 5/27/2024
Certificate Expiration Date 5/26/2026
Facility Type Physician Office
Lab Director CRAIG E. HERRMAN

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