15D2051987 CLIA NUMBER - ST MARY MEDICAL CENTER OUTPATIENT CENTER

Laboratory Demographics

  • CLIA Code: 15D2051987
  • Facility Name: ST MARY MEDICAL CENTER OUTPATIENT CENTER
  • Facility Address: 3800 ST MARY DR - POCT LAB
    VALPARAISO, IN
    ZIP 46383
  • Facility Phone: 219 947-6300
  • Facility Type: Other - OUTPT CENTER
  • Facility Type: Waiver
  • Lab Director: DR. TODD DEJULIO
  • NPI Number: 1710420153
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 15D2051987
LAB Type Other - OUTPT CENTER
Facility Name ST MARY MEDICAL CENTER OUTPATIENT CENTER
Street 3800 ST MARY DR - POCT LAB
City VALPARAISO
State IN
ZIP 46383
Phone 219 947-6300
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 1/3/2025
Certificate Expiration Date 1/2/2027
Facility Type Other - OUTPT CENTER
Lab Director DR. TODD DEJULIO

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