15D2117954 CLIA NUMBER - MARATHON HEALTH AT AMC - LYTLE

Laboratory Demographics

  • CLIA Code: 15D2117954
  • Facility Name: MARATHON HEALTH AT AMC - LYTLE
  • Facility Address: 220 VIRGINIA AVE, STE 1-1200
    INDIANAPOLIS, IN
    ZIP 46204
  • Facility Phone: 802 857-0400
  • Facility Type: Other - ONSITE HEALTH CENTER
  • Facility Type: Microscopy
  • Lab Director: GRETCHEN HUFFMAN
  • NPI Number: 1114684701
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 15D2117954
LAB Type Other - ONSITE HEALTH CENTER
Facility Name MARATHON HEALTH AT AMC - LYTLE
Street 220 VIRGINIA AVE, STE 1-1200
City INDIANAPOLIS
State IN
ZIP 46204
Phone 802 857-0400
Certificate Type Certificate for Provider-Performed Microscopy Procedures (PPMP)
Certificate Type Description This certificate is issued to a laboratory in which a physician, midlevel practitioner or dentist performs no tests other than the microscopy procedures. This certificate permits the laboratory to also perform waived tests.
Certificate Effective Date 8/26/2024
Certificate Expiration Date 8/25/2026
Facility Type Other - ONSITE HEALTH CENTER
Lab Director GRETCHEN HUFFMAN

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