15D2125387 CLIA NUMBER - COMMUNITY CANCER CENTER NORTH IMAGING

Laboratory Demographics

CLIA Number: 15D2125387

Facility Name: COMMUNITY CANCER CENTER NORTH IMAGING

Facility Address:
7979 N SHADELAND AVE
INDIANAPOLIS, IN
ZIP 46250
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Facility Phone Number: 317 497-2842

Facility Type: Other - OUTPATIENT IMAGING

Certificate Type: Waiver

NPI Number: 1265945810

Taxonomy: 213E00000X - Podiatrist
A podiatrist is a person qualified by a Doctor of Podiatric Medicine (D.P.M.) degree, licensed by the state, and practicing within the scope of that license. Podiatrists diagnose and treat foot diseases and deformities. They perform medical, surgical and other operative procedures, prescribe corrective devices and prescribe and administer drugs and physical therapy.

CLIA Record

Field Name	Field Value
CLIA Number	15D2125387
LAB Type	Other - OUTPATIENT IMAGING
Facility Name	COMMUNITY CANCER CENTER NORTH IMAGING
Street	7979 N SHADELAND AVE
City	INDIANAPOLIS
State	IN
ZIP	46250
Phone	317 497-2842
CertificateType	4
CertificateEffectiveDate	2/7/2023
CertificateExpirationDate	2/6/2025
FacilityType	Waiver

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This page was last updated on: 4/23/2024