15D2038922 CLIA NUMBER - MEDSTAT LLC

Laboratory Demographics

  • CLIA Code: 15D2038922
  • Facility Name: MEDSTAT LLC
  • Facility Address: 203 N LAKE ST
    WARSAW, IN
    ZIP 46580
  • Facility Phone: 574 372-7637
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: SCOTT H. EHMEN
  • NPI Number: 1902204076
  • Taxonomy: 261QU0200X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 15D2038922
LAB Type Physician Office
Facility Name MEDSTAT LLC
Street 203 N LAKE ST
City WARSAW
State IN
ZIP 46580
Phone 574 372-7637
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/28/2024
Certificate Expiration Date 3/27/2026
Facility Type Physician Office
Lab Director SCOTT H. EHMEN

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