15D2117665 CLIA NUMBER - 219 HEALTH NETWORK, INC

Laboratory Demographics

  • CLIA Code: 15D2117665
  • Facility Name: 219 HEALTH NETWORK, INC
  • Facility Address: 4320 FIR STREET STE 211
    EAST CHICAGO, IN
    ZIP 46312
  • Facility Phone: 219 703-2577
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: LISA RICHARDSON
  • NPI Number: 1578025896
  • Taxonomy: 261QF0400X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 15D2117665
LAB Type Physician Office
Facility Name 219 HEALTH NETWORK, INC
Street 4320 FIR STREET STE 211
City EAST CHICAGO
State IN
ZIP 46312
Phone 219 703-2577
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/22/2024
Certificate Expiration Date 8/21/2026
Facility Type Physician Office
Lab Director LISA RICHARDSON

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