15D2140415 CLIA NUMBER - PARK CENTER, INC DECATUR OFFICE

Laboratory Demographics

  • CLIA Code: 15D2140415
  • Facility Name: PARK CENTER, INC DECATUR OFFICE
  • Facility Address: 809 HIGH STREET
    DECATUR, IN
    ZIP 46733
  • Facility Phone: 260 724-9669
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: AHSAN MAHMOOD
  • NPI Number: 1366719171
  • Taxonomy: 261QM0801X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 15D2140415
LAB Type Physician Office
Facility Name PARK CENTER, INC DECATUR OFFICE
Street 809 HIGH STREET
City DECATUR
State IN
ZIP 46733
Phone 260 724-9669
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 11/21/2023
Certificate Expiration Date 11/20/2025
Facility Type Physician Office
Lab Director AHSAN MAHMOOD

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