15D2097101 CLIA NUMBER - IUHMG PRIMARY CARE

Laboratory Demographics

  • CLIA Code: 15D2097101
  • Facility Name: IUHMG PRIMARY CARE
  • Facility Address: 404 E WASHINGTON ST STE A
    INDIANAPOLIS, IN
    ZIP 46204
  • Facility Phone: 317 944-0513
  • Facility Type: Physician Office
  • Facility Type: Microscopy
  • Lab Director: KEVIN GEBKE
  • NPI Number: 1174909311
  • Taxonomy: 261Q00000X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 15D2097101
LAB Type Physician Office
Facility Name IUHMG PRIMARY CARE
Street 404 E WASHINGTON ST STE A
City INDIANAPOLIS
State IN
ZIP 46204
Phone 317 944-0513
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 6/9/2025
Certificate Expiration Date 6/8/2027
Facility Type Physician Office
Lab Director KEVIN GEBKE

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