15D2157717 CLIA NUMBER - MIDWEST EXPRESS CARE 4, LLC

Laboratory Demographics

  • CLIA Code: 15D2157717
  • Facility Name: MIDWEST EXPRESS CARE 4, LLC
  • Facility Address: 5521 LINCOLN HWY 1A
    CROWN POINT, IN
    ZIP 46307
  • Facility Phone: 219 769-1362
  • Facility Type: Other - URGENT CARE
  • Facility Type: Waiver
  • Lab Director: DR. MICHELE KELLER
  • NPI Number: 1588133680
  • Taxonomy: 261QU0200X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 15D2157717
LAB Type Other - URGENT CARE
Facility Name MIDWEST EXPRESS CARE 4, LLC
Street 5521 LINCOLN HWY 1A
City CROWN POINT
State IN
ZIP 46307
Phone 219 769-1362
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 11/13/2024
Certificate Expiration Date 11/12/2026
Facility Type Other - URGENT CARE
Lab Director DR. MICHELE KELLER

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