15D2084748 CLIA NUMBER - CONCENTRA - INDIANAPOLIS RAYMOND

Laboratory Demographics

  • CLIA Code: 15D2084748
  • Facility Name: CONCENTRA - INDIANAPOLIS RAYMOND
  • Facility Address: 5603 W RAYMOND ST SUITE A-D #10
    INDIANAPOLIS, IN
    ZIP 46241
  • Facility Phone: (317) 241-8266
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: JOSEPH KAVANAUGH
  • NPI Number: 1881875524
  • Taxonomy: 291U00000X - Clinical Medical Laboratory

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CLIA Record

Field Name Field Value
CLIA Number 15D2084748
LAB Type Physician Office
Facility Name CONCENTRA - INDIANAPOLIS RAYMOND
Street 5603 W RAYMOND ST SUITE A-D #10
City INDIANAPOLIS
State IN
ZIP 46241
Phone 3172418266
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/30/2024
Certificate Expiration Date 9/29/2026
Facility Type Physician Office
Lab Director JOSEPH KAVANAUGH

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This page was last updated on: 5/18/2026