15D2107610 CLIA NUMBER - AMERICAN HEALTH NETWORK OF INDIANA, LLC

Laboratory Demographics

  • CLIA Code: 15D2107610
  • Facility Name: AMERICAN HEALTH NETWORK OF INDIANA, LLC
  • Facility Address: 99 E DEWEY STREET
    LOGANSPORT, IN
    ZIP 46947
  • Facility Phone: 317 582-3929
  • Facility Type: Industrial
  • Facility Type: Waiver
  • Lab Director: DEREK OLDHAM
  • NPI Number: 1609239169
  • Taxonomy: 261QP2300X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 15D2107610
LAB Type Industrial
Facility Name AMERICAN HEALTH NETWORK OF INDIANA, LLC
Street 99 E DEWEY STREET
City LOGANSPORT
State IN
ZIP 46947
Phone 317 582-3929
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 1/19/2024
Certificate Expiration Date 1/18/2026
Facility Type Industrial
Lab Director DEREK OLDHAM

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This page was last updated on: 3/20/2025