15D2148766 CLIA NUMBER - VALLE VISTA HOSPITAL LLC

Laboratory Demographics

  • CLIA Code: 15D2148766
  • Facility Name: VALLE VISTA HOSPITAL LLC
  • Facility Address: 65 AIRPORT PARKWAY SUITE 104
    GREENWOOD, IN
    ZIP 46143
  • Facility Phone: 317 887-1348
  • Facility Type: Other - OPIOID TREATMENT PROGRAM
  • Facility Type: Waiver
  • Lab Director: SIMON FENG
  • NPI Number: 1699722405
  • Taxonomy: 283Q00000X - Psychiatric Hospital

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CLIA Record

Field Name Field Value
CLIA Number 15D2148766
LAB Type Other - OPIOID TREATMENT PROGRAM
Facility Name VALLE VISTA HOSPITAL LLC
Street 65 AIRPORT PARKWAY SUITE 104
City GREENWOOD
State IN
ZIP 46143
Phone 317 887-1348
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 5/18/2024
Certificate Expiration Date 5/17/2026
Facility Type Other - OPIOID TREATMENT PROGRAM
Lab Director SIMON FENG

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