15D2196604 CLIA NUMBER - LAKE GEORGE SURGERY CENTER

Laboratory Demographics

  • CLIA Code: 15D2196604
  • Facility Name: LAKE GEORGE SURGERY CENTER
  • Facility Address: 6245 N OLD 27 SUITE A10
    FREMONT, IN
    ZIP 46737
  • Facility Phone: 517 462-8283
  • Facility Type: Ambulatory Surgery Center
  • Facility Type: Waiver
  • Lab Director: KATHY J. MECCIA
  • NPI Number: 1457960536
  • Taxonomy: 261QA1903X - Clinic/Center

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 15D2196604
LAB Type Ambulatory Surgery Center
Facility Name LAKE GEORGE SURGERY CENTER
Street 6245 N OLD 27 SUITE A10
City FREMONT
State IN
ZIP 46737
Phone 517 462-8283
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/19/2024
Certificate Expiration Date 10/18/2026
Facility Type Ambulatory Surgery Center
Lab Director KATHY J. MECCIA

Download Record

Download this CLIA record record in Text format: Export

Download this CLIA record record in Excel (CSV) format: Export

Download this CLIA record record in XML format: Export

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