15D2122288 CLIA NUMBER - FORT WAYNE RETINA, PC (MIDWEST EYE INSTITUTE)

Laboratory Demographics

  • CLIA Code: 15D2122288
  • Facility Name: FORT WAYNE RETINA, PC (MIDWEST EYE INSTITUTE)
  • Facility Address: 11220 ILLINOIS STREET, SUITE 150
    CARMEL, IN
    ZIP 46032
  • Facility Phone: 317 817-1822
  • Facility Type: Practitioner Other
  • Facility Type: Waiver
  • Lab Director: NEIL P. FINNEN
  • NPI Number: 1053358614
  • Taxonomy: 207W00000X - Ophthalmology

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CLIA Record

Field Name Field Value
CLIA Number 15D2122288
LAB Type Practitioner Other
Facility Name FORT WAYNE RETINA, PC (MIDWEST EYE INSTITUTE)
Street 11220 ILLINOIS STREET, SUITE 150
City CARMEL
State IN
ZIP 46032
Phone 317 817-1822
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 11/23/2024
Certificate Expiration Date 11/22/2026
Facility Type Practitioner Other
Lab Director NEIL P. FINNEN

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