15D2072653 CLIA NUMBER - CHRISTIAN CLINIC PC

Laboratory Demographics

  • CLIA Code: 15D2072653
  • Facility Name: CHRISTIAN CLINIC PC
  • Facility Address: 716 SOUTH COLLEGE AVENUE
    RENSSELAER, IN
    ZIP 47978
  • Facility Phone: 219 866-0485
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: JAMES G. WAKEFIELD
  • NPI Number: 1558763987
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 15D2072653
LAB Type Physician Office
Facility Name CHRISTIAN CLINIC PC
Street 716 SOUTH COLLEGE AVENUE
City RENSSELAER
State IN
ZIP 47978
Phone 219 866-0485
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 7/24/2025
Certificate Expiration Date 7/23/2027
Facility Type Physician Office
Lab Director JAMES G. WAKEFIELD

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