15D2130084 CLIA NUMBER - MARION CO JUVENILE DETENTION CENTER

Laboratory Demographics

  • CLIA Code: 15D2130084
  • Facility Name: MARION CO JUVENILE DETENTION CENTER
  • Facility Address: 3030 PROSPECT STREET
    INDIANAPOLIS, IN
    ZIP 46203
  • Facility Phone: 317 327-8300
  • Facility Type: Other - JAIL
  • Facility Type: Microscopy
  • Lab Director: PAUL G. DENGLER
  • NPI Number: 1821043977
  • Taxonomy: 261QE0700X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 15D2130084
LAB Type Other - JAIL
Facility Name MARION CO JUVENILE DETENTION CENTER
Street 3030 PROSPECT STREET
City INDIANAPOLIS
State IN
ZIP 46203
Phone 317 327-8300
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 5/2/2025
Certificate Expiration Date 5/1/2027
Facility Type Other - JAIL
Lab Director PAUL G. DENGLER

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