15D2046888 CLIA NUMBER - MEMORIAL EPWORTH CENTER

Laboratory Demographics

  • CLIA Code: 15D2046888
  • Facility Name: MEMORIAL EPWORTH CENTER
  • Facility Address: 420 N NILES AVE
    SOUTH BEND, IN
    ZIP 46617
  • Facility Phone: 574 647-8381
  • Facility Type: Hospital
  • Facility Type: Waiver
  • Lab Director: JAGADEESH REDDY
  • NPI Number: 1730225848
  • Taxonomy: 2085U0001X - Radiology

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CLIA Record

Field Name Field Value
CLIA Number 15D2046888
LAB Type Hospital
Facility Name MEMORIAL EPWORTH CENTER
Street 420 N NILES AVE
City SOUTH BEND
State IN
ZIP 46617
Phone 574 647-8381
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/13/2024
Certificate Expiration Date 9/12/2026
Facility Type Hospital
Lab Director JAGADEESH REDDY

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