15D2046506 CLIA NUMBER - PREFERRED PEDIATRICS OF LAFAYETTE

Laboratory Demographics

  • CLIA Code: 15D2046506
  • Facility Name: PREFERRED PEDIATRICS OF LAFAYETTE
  • Facility Address: 3774 BAYLEY DR, STE B
    LAFAYETTE, IN
    ZIP 47905
  • Facility Phone: 765 807-8180
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: M ANN JONKMAN
  • NPI Number: 1679838189
  • Taxonomy: 208000000X - Pediatrics

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CLIA Record

Field Name Field Value
CLIA Number 15D2046506
LAB Type Physician Office
Facility Name PREFERRED PEDIATRICS OF LAFAYETTE
Street 3774 BAYLEY DR, STE B
City LAFAYETTE
State IN
ZIP 47905
Phone 765 807-8180
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/5/2024
Certificate Expiration Date 9/4/2026
Facility Type Physician Office
Lab Director M ANN JONKMAN

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