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15D2052377 CLIA NUMBER - COMMUNITY PHY OF IND INC/MEDCHECK SPEEDWAY

Laboratory Demographics

CLIA Number: 15D2052377

Facility Name: COMMUNITY PHY OF IND INC/MEDCHECK SPEEDWAY

Facility Address:
1011 MAIN ST SUITE 140
INDIANAPOLIS, IN
ZIP 46224
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Facility Phone Number: 317 957-9000

Facility Type: Physician Office

Certificate Type: Waiver
NPI Number: 1457743809

Taxonomy: 207Q00000X - Family Medicine
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.

CLIA Record

Field Name Field Value
CLIA Number 15D2052377
LAB Type Physician Office
Facility Name COMMUNITY PHY OF IND INC/MEDCHECK SPEEDWAY
Street 1011 MAIN ST SUITE 140
City INDIANAPOLIS
State IN
ZIP 46224
Phone 317 957-9000
CertificateType 4
CertificateEffectiveDate 1/9/2023
CertificateExpirationDate 1/8/2025
FacilityType Waiver

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This page was last updated on: 4/23/2024