15D2020778 CLIA NUMBER - UTHMAN CAVALLO, MD, LLC

Laboratory Demographics

  • CLIA Code: 15D2020778
  • Facility Name: UTHMAN CAVALLO, MD, LLC
  • Facility Address: 53800 GENERATIONS DR
    SOUTH BEND, IN
    ZIP 46635
  • Facility Phone: 574 273-3880
  • Facility Type: Physician Office
  • Facility Type: Microscopy
  • Lab Director: UTHMAN CAVALLO
  • NPI Number: 1528013372
  • Taxonomy: 207V00000X - Obstetrics & Gynecology

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CLIA Record

Field Name Field Value
CLIA Number 15D2020778
LAB Type Physician Office
Facility Name UTHMAN CAVALLO, MD, LLC
Street 53800 GENERATIONS DR
City SOUTH BEND
State IN
ZIP 46635
Phone 574 273-3880
Certificate Type Certificate for Provider-Performed Microscopy Procedures (PPMP)
Certificate Type Description This certificate is issued to a laboratory in which a physician, midlevel practitioner or dentist performs no tests other than the microscopy procedures. This certificate permits the laboratory to also perform waived tests.
Certificate Effective Date 2/28/2025
Certificate Expiration Date 2/27/2027
Facility Type Physician Office
Lab Director UTHMAN CAVALLO

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This page was last updated on: 3/20/2025