15D2057763 CLIA NUMBER - MARATHON HEALTH AT CENTIER

Laboratory Demographics

  • CLIA Code: 15D2057763
  • Facility Name: MARATHON HEALTH AT CENTIER
  • Facility Address: 600 E 84TH AVE, SUITE 100
    MERRILLVILLE, IN
    ZIP 46410
  • Facility Phone: 219 801-3927
  • Facility Type: Physician Office
  • Facility Type: Microscopy
  • Lab Director: CARRIE SHAFFER
  • NPI Number: 1003518598
  • Taxonomy: 261Q00000X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 15D2057763
LAB Type Physician Office
Facility Name MARATHON HEALTH AT CENTIER
Street 600 E 84TH AVE, SUITE 100
City MERRILLVILLE
State IN
ZIP 46410
Phone 219 801-3927
Certificate Type Certificate for Provider-Performed Microscopy Procedures (PPMP)
Certificate Type Description This certificate is issued to a laboratory in which a physician, midlevel practitioner or dentist performs no tests other than the microscopy procedures. This certificate permits the laboratory to also perform waived tests.
Certificate Effective Date 4/23/2025
Certificate Expiration Date 4/22/2027
Facility Type Physician Office
Lab Director CARRIE SHAFFER

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