15D2155204 CLIA NUMBER - COLUMBUS DIAGNOSTIC IMAGING LLC

Laboratory Demographics

CLIA Number: 15D2155204

Facility Name: COLUMBUS DIAGNOSTIC IMAGING LLC

Facility Address:
790 CREEKVIEW DRIVE
COLUMBUS, IN
ZIP 47201
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Facility Phone Number: 812 376-1000

Facility Type: Other - INDEPENDENT DIAGNOSTIC TE

Certificate Type: Waiver

NPI Number: 1891800959

Taxonomy: 261QR0200X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	15D2155204
LAB Type	Other - INDEPENDENT DIAGNOSTIC TE
Facility Name	COLUMBUS DIAGNOSTIC IMAGING LLC
Street	790 CREEKVIEW DRIVE
City	COLUMBUS
State	IN
ZIP	47201
Phone	812 376-1000
CertificateType	4
CertificateEffectiveDate	9/25/2022
CertificateExpirationDate	9/24/2024
FacilityType	Waiver

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This page was last updated on: 4/23/2024