15D2097455 CLIA NUMBER - MIDWEST WELLNESS

Laboratory Demographics

  • CLIA Code: 15D2097455
  • Facility Name: MIDWEST WELLNESS
  • Facility Address: 6822 E 82ND ST, STE 300
    INDIANAPOLIS, IN
    ZIP 46250
  • Facility Phone: 317 548-4666
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: KESA SRINIVASU
  • NPI Number: 1497108468
  • Taxonomy: 207R00000X - Internal Medicine

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CLIA Record

Field Name Field Value
CLIA Number 15D2097455
LAB Type Physician Office
Facility Name MIDWEST WELLNESS
Street 6822 E 82ND ST, STE 300
City INDIANAPOLIS
State IN
ZIP 46250
Phone 317 548-4666
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 6/16/2025
Certificate Expiration Date 6/15/2027
Facility Type Physician Office
Lab Director KESA SRINIVASU

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