15D1091777 CLIA NUMBER - ALLERGY ASTHMA CARE PC

Laboratory Demographics

  • CLIA Code: 15D1091777
  • Facility Name: ALLERGY ASTHMA CARE PC
  • Facility Address: 11039 BROADWAY STE B
    CROWN POINT, IN
    ZIP 46307
  • Facility Phone: 219 756-6100
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: KENNETH W. BLUMENTHAL
  • NPI Number: 1265440390
  • Taxonomy: 174400000X - Specialist

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CLIA Record

Field Name Field Value
CLIA Number 15D1091777
LAB Type Physician Office
Facility Name ALLERGY ASTHMA CARE PC
Street 11039 BROADWAY STE B
City CROWN POINT
State IN
ZIP 46307
Phone 219 756-6100
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 5/19/2025
Certificate Expiration Date 5/18/2027
Facility Type Physician Office
Lab Director KENNETH W. BLUMENTHAL

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