15D2191004 CLIA NUMBER - PRIMARY CARE AT HOME, INC

Laboratory Demographics

  • CLIA Code: 15D2191004
  • Facility Name: PRIMARY CARE AT HOME, INC
  • Facility Address: 7750 MICHIGAN ROAD
    INDIANAPOLIS, IN
    ZIP 46268
  • Facility Phone: 317 471-0774
  • Facility Type: Other - HOUSECALL MEDICAL PRACTIC
  • Facility Type: Waiver
  • Lab Director: ETELKA FROYMOVICH
  • NPI Number: 1336757103
  • Taxonomy: 207R00000X - Internal Medicine

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CLIA Record

Field Name Field Value
CLIA Number 15D2191004
LAB Type Other - HOUSECALL MEDICAL PRACTIC
Facility Name PRIMARY CARE AT HOME, INC
Street 7750 MICHIGAN ROAD
City INDIANAPOLIS
State IN
ZIP 46268
Phone 317 471-0774
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/21/2024
Certificate Expiration Date 8/20/2026
Facility Type Other - HOUSECALL MEDICAL PRACTIC
Lab Director ETELKA FROYMOVICH

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