15D2105540 CLIA NUMBER - LPC SURGERY CENTER LLC DBA LAFAYETTE SURGERY CTR

Laboratory Demographics

  • CLIA Code: 15D2105540
  • Facility Name: LPC SURGERY CENTER LLC DBA LAFAYETTE SURGERY CTR
  • Facility Address: 770 PARK EAST BLVD, STE A
    LAFAYETTE, IN
    ZIP 47905
  • Facility Phone: 765 714-4344
  • Facility Type: Ambulatory Surgery Center
  • Facility Type: Waiver
  • Lab Director: SHAZIA SIDDIQUI
  • NPI Number: 1447612114
  • Taxonomy: 261QA1903X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 15D2105540
LAB Type Ambulatory Surgery Center
Facility Name LPC SURGERY CENTER LLC DBA LAFAYETTE SURGERY CTR
Street 770 PARK EAST BLVD, STE A
City LAFAYETTE
State IN
ZIP 47905
Phone 765 714-4344
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 11/30/2023
Certificate Expiration Date 11/29/2025
Facility Type Ambulatory Surgery Center
Lab Director SHAZIA SIDDIQUI

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