15D2169755 CLIA NUMBER - MIDS LLC, DBA MICHIANA INFECTIOUS DISEASE SPECIALISTS

Laboratory Demographics

  • CLIA Code: 15D2169755
  • Facility Name: MIDS LLC, DBA MICHIANA INFECTIOUS DISEASE SPECIALISTS
  • Facility Address: 3838 N MAIN ST, STE 1C
    MISHAWAKA, IN
    ZIP 46545
  • Facility Phone: 574 404-3980
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: WON CHUNG
  • NPI Number: 1366097016
  • Taxonomy: 207RI0200X - Internal Medicine

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CLIA Record

Field Name Field Value
CLIA Number 15D2169755
LAB Type Physician Office
Facility Name MIDS LLC, DBA MICHIANA INFECTIOUS DISEASE SPECIALISTS
Street 3838 N MAIN ST, STE 1C
City MISHAWAKA
State IN
ZIP 46545
Phone 574 404-3980
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 7/26/2025
Certificate Expiration Date 7/25/2027
Facility Type Physician Office
Lab Director WON CHUNG

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