15D2064363 CLIA NUMBER - MICHAEL BOXUM, DO

Laboratory Demographics

  • CLIA Code: 15D2064363
  • Facility Name: MICHAEL BOXUM, DO
  • Facility Address: 754 N MCCOOL RD
    VALPARAISO, IN
    ZIP 46385
  • Facility Phone: 219 759-5500
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: MICHAEL S. BOXUM
  • NPI Number: 1235105685
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 15D2064363
LAB Type Physician Office
Facility Name MICHAEL BOXUM, DO
Street 754 N MCCOOL RD
City VALPARAISO
State IN
ZIP 46385
Phone 219 759-5500
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/19/2025
Certificate Expiration Date 8/18/2027
Facility Type Physician Office
Lab Director MICHAEL S. BOXUM

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