15D2001536 CLIA NUMBER - JULIAN Y UNGAR-SARGON MD PHD

Laboratory Demographics

  • CLIA Code: 15D2001536
  • Facility Name: JULIAN Y UNGAR-SARGON MD PHD
  • Facility Address: 123 S MCKINLEY AVE
    RENSSELAER, IN
    ZIP 47978
  • Facility Phone: 219 866-7222
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: DR. JULIAN Y. UNGAR-SARGON
  • NPI Number: 1376642900
  • Taxonomy: 2084N0400X - Psychiatry & Neurology

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CLIA Record

Field Name Field Value
CLIA Number 15D2001536
LAB Type Physician Office
Facility Name JULIAN Y UNGAR-SARGON MD PHD
Street 123 S MCKINLEY AVE
City RENSSELAER
State IN
ZIP 47978
Phone 219 866-7222
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 12/22/2023
Certificate Expiration Date 12/21/2025
Facility Type Physician Office
Lab Director DR. JULIAN Y. UNGAR-SARGON

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This page was last updated on: 6/4/2025