15D2097664 CLIA NUMBER - LA PORTE CLINIC COMPANY, LLC D/B/A NORTHWEST MEDICAL GROUP - LA PORTE

Laboratory Demographics

  • CLIA Code: 15D2097664
  • Facility Name: LA PORTE CLINIC COMPANY, LLC D/B/A NORTHWEST MEDICAL GROUP - LA PORTE
  • Facility Address: 401 NEWPORT BOULEVARD
    LA PORTE, IN
    ZIP 46350
  • Facility Phone: 219 575-6244
  • Facility Type: Community Clinic
  • Facility Type: Waiver
  • Lab Director: ALEJANDRO ALVAREZ
  • NPI Number: 1356447007
  • Taxonomy: 152W00000X - Optometrist

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CLIA Record

Field Name Field Value
CLIA Number 15D2097664
LAB Type Community Clinic
Facility Name LA PORTE CLINIC COMPANY, LLC D/B/A NORTHWEST MEDICAL GROUP - LA PORTE
Street 401 NEWPORT BOULEVARD
City LA PORTE
State IN
ZIP 46350
Phone 219 575-6244
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 7/13/2024
Certificate Expiration Date 7/12/2026
Facility Type Community Clinic
Lab Director ALEJANDRO ALVAREZ

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