15D2129231 CLIA NUMBER - INDY DERM, LLC

Laboratory Demographics

  • CLIA Code: 15D2129231
  • Facility Name: INDY DERM, LLC
  • Facility Address: 521 E COUNTY LINE ROAD SUITE E
    GREENWOOD, IN
    ZIP 46143
  • Facility Phone: 317 215-0928
  • Facility Type: Physician Office
  • Facility Type: Microscopy
  • Lab Director: EMILY C. KELLER
  • NPI Number: 1497105191
  • Taxonomy: 207ND0900X - Dermatology

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CLIA Record

Field Name Field Value
CLIA Number 15D2129231
LAB Type Physician Office
Facility Name INDY DERM, LLC
Street 521 E COUNTY LINE ROAD SUITE E
City GREENWOOD
State IN
ZIP 46143
Phone 317 215-0928
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 4/17/2025
Certificate Expiration Date 4/16/2027
Facility Type Physician Office
Lab Director EMILY C. KELLER

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