15D2122111 CLIA NUMBER - LA PORTE DIALYSIS

Laboratory Demographics

  • CLIA Code: 15D2122111
  • Facility Name: LA PORTE DIALYSIS
  • Facility Address: 1406 E LINCOLNWAY, STE A
    LA PORTE, IN
    ZIP 46350
  • Facility Phone: 219 324-3080
  • Facility Type: End Stage Renal Disease Dialysis Facility
  • Facility Type: Waiver
  • Lab Director: SYED M. RIZVI
  • NPI Number: 1568916971
  • Taxonomy: 261QE0700X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 15D2122111
LAB Type End Stage Renal Disease Dialysis Facility
Facility Name LA PORTE DIALYSIS
Street 1406 E LINCOLNWAY, STE A
City LA PORTE
State IN
ZIP 46350
Phone 219 324-3080
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 11/21/2024
Certificate Expiration Date 11/20/2026
Facility Type End Stage Renal Disease Dialysis Facility
Lab Director SYED M. RIZVI

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