15D2163173 CLIA NUMBER - CLOVER LLC

Laboratory Demographics

  • CLIA Code: 15D2163173
  • Facility Name: CLOVER LLC
  • Facility Address: 9765 RANDALL DRIVE, SUITE C
    CARMEL, IN
    ZIP 46280
  • Facility Phone: 844 366-2587
  • Facility Type: Home Health Agency
  • Facility Type: Waiver
  • Lab Director: CARRIE K. TIDWELL
  • NPI Number: 1275011355
  • Taxonomy: 251E00000X - Home Health

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CLIA Record

Field Name Field Value
CLIA Number 15D2163173
LAB Type Home Health Agency
Facility Name CLOVER LLC
Street 9765 RANDALL DRIVE, SUITE C
City CARMEL
State IN
ZIP 46280
Phone 844 366-2587
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/8/2025
Certificate Expiration Date 3/7/2027
Facility Type Home Health Agency
Lab Director CARRIE K. TIDWELL

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