15D2163915 CLIA NUMBER - NORTHSIDE GASTROENTEROLOGY, INC, PC

Laboratory Demographics

  • CLIA Code: 15D2163915
  • Facility Name: NORTHSIDE GASTROENTEROLOGY, INC, PC
  • Facility Address: 8424 NAAB RD, SUITE 3J
    INDIANAPOLIS, IN
    ZIP 46260
  • Facility Phone: 317 872-7396
  • Facility Type: Other - READ ONLY PATHOLOGY LABOR
  • Facility Type: Certificate of Compliance
  • Lab Director: ANJALI S. GODAMBE
  • NPI Number: 1568578201
  • Taxonomy: 207RG0100X - Internal Medicine

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CLIA Record

Field Name Field Value
CLIA Number 15D2163915
LAB Type Other - READ ONLY PATHOLOGY LABOR
Facility Name NORTHSIDE GASTROENTEROLOGY, INC, PC
Street 8424 NAAB RD, SUITE 3J
City INDIANAPOLIS
State IN
ZIP 46260
Phone 317 872-7396
Certificate Type Certificate of Compliance
Certificate Type Description This certificate is issued to a laboratory after an inspection that finds the laboratory to be in compliance with all applicable CLIA requirements.
Certificate Effective Date 8/19/2025
Certificate Expiration Date 8/18/2027
Facility Type Other - READ ONLY PATHOLOGY LABOR
Lab Director ANJALI S. GODAMBE

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