15D2197033 CLIA NUMBER - MIDWEST EXPRESS CARE 4, LLC

Laboratory Demographics

  • CLIA Code: 15D2197033
  • Facility Name: MIDWEST EXPRESS CARE 4, LLC
  • Facility Address: 6131 US HIGHWAY 6 SUITE C
    PORTAGE, IN
    ZIP 46368
  • Facility Phone: (219) 841-8788
  • Facility Type: Other - URGENT CARE CLINIC
  • Facility Type: Waiver
  • Lab Director: DR. MICHELE KELLER
  • NPI Number: 1154921294
  • Taxonomy: 261QU0200X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 15D2197033
LAB Type Other - URGENT CARE CLINIC
Facility Name MIDWEST EXPRESS CARE 4, LLC
Street 6131 US HIGHWAY 6 SUITE C
City PORTAGE
State IN
ZIP 46368
Phone 2198418788
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/21/2024
Certificate Expiration Date 10/20/2026
Facility Type Other - URGENT CARE CLINIC
Lab Director DR. MICHELE KELLER

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This page was last updated on: 5/18/2026