15D2185747 CLIA NUMBER - GARY CITY WORKING AND PROCEDURE CLINIC LLC

Laboratory Demographics

CLIA Number: 15D2185747

Facility Name: GARY CITY WORKING AND PROCEDURE CLINIC LLC

Facility Address:
1701 BROADWAY
GARY, IN
ZIP 46407
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Facility Phone Number: 219 882-2980

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1164033676

Taxonomy: 207Q00000X - Family Medicine
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.

CLIA Record

Field Name	Field Value
CLIA Number	15D2185747
LAB Type	Physician Office
Facility Name	GARY CITY WORKING AND PROCEDURE CLINIC LLC
Street	1701 BROADWAY
City	GARY
State	IN
ZIP	46407
Phone	219 882-2980
CertificateType	4
CertificateEffectiveDate	6/9/2022
CertificateExpirationDate	6/8/2024
FacilityType	Waiver

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This page was last updated on: 4/23/2024