15D1104070 CLIA NUMBER - LA PORTE CLINIC COMPANY, LLC D/B/A NORTHWEST MEDICAL GROUP - LA PORTE

Laboratory Demographics

  • CLIA Code: 15D1104070
  • Facility Name: LA PORTE CLINIC COMPANY, LLC D/B/A NORTHWEST MEDICAL GROUP - LA PORTE
  • Facility Address: 402 WEST CULVER ROAD
    KNOX, IN
    ZIP 46534
  • Facility Phone: 219 324-0014
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: ERIN DUFF
  • NPI Number: 1467622746
  • Taxonomy: 207R00000X - Internal Medicine

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CLIA Record

Field Name Field Value
CLIA Number 15D1104070
LAB Type Physician Office
Facility Name LA PORTE CLINIC COMPANY, LLC D/B/A NORTHWEST MEDICAL GROUP - LA PORTE
Street 402 WEST CULVER ROAD
City KNOX
State IN
ZIP 46534
Phone 219 324-0014
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/25/2025
Certificate Expiration Date 8/24/2027
Facility Type Physician Office
Lab Director ERIN DUFF

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