15D2148851 CLIA NUMBER - GILLUM FACIAL PLASTIC SURGERY-D/B/A GILLUM SINUS & ALLERGY

Laboratory Demographics

  • CLIA Code: 15D2148851
  • Facility Name: GILLUM FACIAL PLASTIC SURGERY-D/B/A GILLUM SINUS & ALLERGY
  • Facility Address: 801 W GARDNER DR
    MARION, IN
    ZIP 46952
  • Facility Phone: 765 651-4278
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: TIMOTHY G. GILLUM
  • NPI Number: 1063563617
  • Taxonomy: 174400000X - Specialist

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CLIA Record

Field Name Field Value
CLIA Number 15D2148851
LAB Type Physician Office
Facility Name GILLUM FACIAL PLASTIC SURGERY-D/B/A GILLUM SINUS & ALLERGY
Street 801 W GARDNER DR
City MARION
State IN
ZIP 46952
Phone 765 651-4278
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 5/21/2024
Certificate Expiration Date 5/20/2026
Facility Type Physician Office
Lab Director TIMOTHY G. GILLUM

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