15D2144793 CLIA NUMBER - MY MOBILE MD LLC

Laboratory Demographics

  • CLIA Code: 15D2144793
  • Facility Name: MY MOBILE MD LLC
  • Facility Address: 429 E VERMONT ST STE 110
    INDIANAPOLIS, IN
    ZIP 46202
  • Facility Phone: 317 559-0950
  • Facility Type: Practitioner Other
  • Facility Type: Waiver
  • Lab Director: STEVE C. MARTIN
  • NPI Number: 1033628680
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 15D2144793
LAB Type Practitioner Other
Facility Name MY MOBILE MD LLC
Street 429 E VERMONT ST STE 110
City INDIANAPOLIS
State IN
ZIP 46202
Phone 317 559-0950
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 2/23/2024
Certificate Expiration Date 2/22/2026
Facility Type Practitioner Other
Lab Director STEVE C. MARTIN

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This page was last updated on: 6/4/2025