15D2202331 CLIA NUMBER - INDIANA DEPARTMENT OF HEALTH DIV OF EMERGENCY PREPAREDNESS

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Laboratory Demographics

CLIA Number: 15D2202331

Facility Name: INDIANA DEPARTMENT OF HEALTH DIV OF EMERGENCY PREPAREDNESS

Facility Address:
2 N MERIDIAN ST
INDIANAPOLIS, IN
ZIP 46204
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Facility Phone Number: 317 233-3218

Facility Type: Mobile Laboratory

Certificate Type: Waiver

NPI Number: 1457875460

Taxonomy: 251K00000X - Public Health or Welfare

CLIA Record

Field Name	Field Value
CLIA Number	15D2202331
LAB Type	Mobile Laboratory
Facility Name	INDIANA DEPARTMENT OF HEALTH DIV OF EMERGENCY PREPAREDNESS
Street	2 N MERIDIAN ST
City	INDIANAPOLIS
State	IN
ZIP	46204
Phone	317 233-3218
CertificateType	4
CertificateEffectiveDate	11/25/2022
CertificateExpirationDate	11/24/2024
FacilityType	Waiver

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