15D2173407 CLIA NUMBER - OKOLOCHA MEDICAL CORP

Laboratory Demographics

  • CLIA Code: 15D2173407
  • Facility Name: OKOLOCHA MEDICAL CORP
  • Facility Address: 2054 GRANT ST
    GARY, IN
    ZIP 46404
  • Facility Phone: 219 949-7540
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: PAUL C. OKOLOCHA
  • NPI Number: 1902851330
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 15D2173407
LAB Type Physician Office
Facility Name OKOLOCHA MEDICAL CORP
Street 2054 GRANT ST
City GARY
State IN
ZIP 46404
Phone 219 949-7540
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/11/2025
Certificate Expiration Date 10/10/2027
Facility Type Physician Office
Lab Director PAUL C. OKOLOCHA

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