15D2054729 CLIA NUMBER - PARKVIEW ENDOCRINOLOGY

Laboratory Demographics

  • CLIA Code: 15D2054729
  • Facility Name: PARKVIEW ENDOCRINOLOGY
  • Facility Address: 11141 PARKVIEW PLAZA DRIVE SUITE 310
    FORT WAYNE, IN
    ZIP 46845
  • Facility Phone: 260 373-7871
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: DR. JEREMY R. GROGG
  • NPI Number: 1063757227
  • Taxonomy: 261QA1903X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 15D2054729
LAB Type Physician Office
Facility Name PARKVIEW ENDOCRINOLOGY
Street 11141 PARKVIEW PLAZA DRIVE SUITE 310
City FORT WAYNE
State IN
ZIP 46845
Phone 260 373-7871
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 2/27/2025
Certificate Expiration Date 2/26/2027
Facility Type Physician Office
Lab Director DR. JEREMY R. GROGG

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