15D2114373 CLIA NUMBER - GREEN PEDIATRICS

Laboratory Demographics

  • CLIA Code: 15D2114373
  • Facility Name: GREEN PEDIATRICS
  • Facility Address: 8247 WICKER AVE
    ST JOHN, IN
    ZIP 46373
  • Facility Phone: 219 662-3931
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: BILJANA UZELAC
  • NPI Number: 1922462811
  • Taxonomy: 208000000X - Pediatrics

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CLIA Record

Field Name Field Value
CLIA Number 15D2114373
LAB Type Physician Office
Facility Name GREEN PEDIATRICS
Street 8247 WICKER AVE
City ST JOHN
State IN
ZIP 46373
Phone 219 662-3931
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 6/13/2024
Certificate Expiration Date 6/12/2026
Facility Type Physician Office
Lab Director BILJANA UZELAC

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