15D2149141 CLIA NUMBER - MARATHON HEALTH AT FISHERS

Laboratory Demographics

  • CLIA Code: 15D2149141
  • Facility Name: MARATHON HEALTH AT FISHERS
  • Facility Address: 12734 PARKSIDE DR
    FISHERS, IN
    ZIP 46038
  • Facility Phone: 802 857-0400
  • Facility Type: Other - ONSITE HEALTH CENTER
  • Facility Type: Microscopy
  • Lab Director: MARK FAKHOURY
  • NPI Number: 1598205221
  • Taxonomy: 208D00000X - General Practice

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CLIA Record

Field Name Field Value
CLIA Number 15D2149141
LAB Type Other - ONSITE HEALTH CENTER
Facility Name MARATHON HEALTH AT FISHERS
Street 12734 PARKSIDE DR
City FISHERS
State IN
ZIP 46038
Phone 802 857-0400
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 5/25/2024
Certificate Expiration Date 5/24/2026
Facility Type Other - ONSITE HEALTH CENTER
Lab Director MARK FAKHOURY

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