15D2161074 CLIA NUMBER - MIDWEST EXPRESS CARE 4 LLC

Laboratory Demographics

  • CLIA Code: 15D2161074
  • Facility Name: MIDWEST EXPRESS CARE 4 LLC
  • Facility Address: 5043 W 81ST AVE
    MERRILLVILLE, IN
    ZIP 46410
  • Facility Phone: (219) 707-5276
  • Facility Type: Other - URGENT CARE
  • Facility Type: Waiver
  • Lab Director: RANDALL R. CHUBE
  • NPI Number: 1255178125
  • Taxonomy: 261QU0200X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 15D2161074
LAB Type Other - URGENT CARE
Facility Name MIDWEST EXPRESS CARE 4 LLC
Street 5043 W 81ST AVE
City MERRILLVILLE
State IN
ZIP 46410
Phone 2197075276
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 1/25/2025
Certificate Expiration Date 1/24/2027
Facility Type Other - URGENT CARE
Lab Director RANDALL R. CHUBE

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This page was last updated on: 5/18/2026