15D2175698 CLIA NUMBER - LOUISVILLE GERIATRIC ASSOCIATES DBA WALL STREET MEDICAL GROUP

Laboratory Demographics

  • CLIA Code: 15D2175698
  • Facility Name: LOUISVILLE GERIATRIC ASSOCIATES DBA WALL STREET MEDICAL GROUP
  • Facility Address: 443 SPRING STREET, SUITE 201
    JEFFERSONVILLE, IN
    ZIP 47130
  • Facility Phone: 812 288-8360
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: MUHAMMAD I. MASROOR
  • NPI Number: 1922337617
  • Taxonomy: 207R00000X - Internal Medicine

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CLIA Record

Field Name Field Value
CLIA Number 15D2175698
LAB Type Physician Office
Facility Name LOUISVILLE GERIATRIC ASSOCIATES DBA WALL STREET MEDICAL GROUP
Street 443 SPRING STREET, SUITE 201
City JEFFERSONVILLE
State IN
ZIP 47130
Phone 812 288-8360
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 11/26/2023
Certificate Expiration Date 11/25/2025
Facility Type Physician Office
Lab Director MUHAMMAD I. MASROOR

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