15D2103980 CLIA NUMBER - ASPIRE INDIANA HEALTH

Laboratory Demographics

CLIA Number: 15D2103980

Facility Name: ASPIRE INDIANA HEALTH

Facility Address:
2009 BROWN STREET
ANDERSON, IN
ZIP 46016
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Facility Phone Number: 317 606-0328

Facility Type: Federally Qualified Health Center

Certificate Type: Waiver

NPI Number: 1124016050

Taxonomy: 261QM0801X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	15D2103980
LAB Type	Federally Qualified Health Center
Facility Name	ASPIRE INDIANA HEALTH
Street	2009 BROWN STREET
City	ANDERSON
State	IN
ZIP	46016
Phone	317 606-0328
CertificateType	4
CertificateEffectiveDate	10/26/2023
CertificateExpirationDate	10/25/2025
FacilityType	Waiver

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This page was last updated on: 4/23/2024