15D2033200 CLIA NUMBER - LAM MEDICAL LLC

Laboratory Demographics

  • CLIA Code: 15D2033200
  • Facility Name: LAM MEDICAL LLC
  • Facility Address: 2040 S CALHOUN ST
    FORT WAYNE, IN
    ZIP 46802
  • Facility Phone: 260 444-5695
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: EROMONSELE O. IDAHOSA
  • NPI Number: 1932856978
  • Taxonomy: 207R00000X - Internal Medicine

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 15D2033200
LAB Type Physician Office
Facility Name LAM MEDICAL LLC
Street 2040 S CALHOUN ST
City FORT WAYNE
State IN
ZIP 46802
Phone 260 444-5695
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 11/28/2023
Certificate Expiration Date 11/27/2025
Facility Type Physician Office
Lab Director EROMONSELE O. IDAHOSA

Download Record

Download this CLIA record record in Text format: Export

Download this CLIA record record in Excel (CSV) format: Export

Download this CLIA record record in XML format: Export

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