15D2169674 CLIA NUMBER - MOON AND ASSOCIATES LLC

Laboratory Demographics

  • CLIA Code: 15D2169674
  • Facility Name: MOON AND ASSOCIATES LLC
  • Facility Address: 12400 N MERIDIAN ST, SUITE 100
    CARMEL, IN
    ZIP 46032
  • Facility Phone: 317 559-3320
  • Facility Type: Physician Office
  • Facility Type: Microscopy
  • Lab Director: AMY L. HOLLAND
  • NPI Number: 1013574102
  • Taxonomy: 207V00000X - Obstetrics & Gynecology

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CLIA Record

Field Name Field Value
CLIA Number 15D2169674
LAB Type Physician Office
Facility Name MOON AND ASSOCIATES LLC
Street 12400 N MERIDIAN ST, SUITE 100
City CARMEL
State IN
ZIP 46032
Phone 317 559-3320
Certificate Type Certificate for Provider-Performed Microscopy Procedures (PPMP)
Certificate Type Description This certificate is issued to a laboratory in which a physician, midlevel practitioner or dentist performs no tests other than the microscopy procedures. This certificate permits the laboratory to also perform waived tests.
Certificate Effective Date 7/24/2025
Certificate Expiration Date 7/23/2027
Facility Type Physician Office
Lab Director AMY L. HOLLAND

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