15D2121920 CLIA NUMBER - EDGEWATER HEALTH

Laboratory Demographics

  • CLIA Code: 15D2121920
  • Facility Name: EDGEWATER HEALTH
  • Facility Address: 1100 WEST 6TH AVE
    GARY, IN
    ZIP 46402
  • Facility Phone: 219 885-4264
  • Facility Type: Federally Qualified Health Center
  • Facility Type: Waiver
  • Lab Director: GERRI BROWNING
  • NPI Number: 1699225698
  • Taxonomy: 207R00000X - Internal Medicine

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CLIA Record

Field Name Field Value
CLIA Number 15D2121920
LAB Type Federally Qualified Health Center
Facility Name EDGEWATER HEALTH
Street 1100 WEST 6TH AVE
City GARY
State IN
ZIP 46402
Phone 219 885-4264
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 11/16/2024
Certificate Expiration Date 11/15/2026
Facility Type Federally Qualified Health Center
Lab Director GERRI BROWNING

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