15D1095878 CLIA NUMBER - IUHMG PRIMARY CARE

Laboratory Demographics

  • CLIA Code: 15D1095878
  • Facility Name: IUHMG PRIMARY CARE
  • Facility Address: 1060 S MAIN ST, STE 4
    TIPTON, IN
    ZIP 46072
  • Facility Phone: 317 944-0513
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: JEFFREY WALKER
  • NPI Number: 1255414975
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 15D1095878
LAB Type Physician Office
Facility Name IUHMG PRIMARY CARE
Street 1060 S MAIN ST, STE 4
City TIPTON
State IN
ZIP 46072
Phone 317 944-0513
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 7/11/2024
Certificate Expiration Date 7/10/2026
Facility Type Physician Office
Lab Director JEFFREY WALKER

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