15D2204244 CLIA NUMBER - GRACE ON WINGS, INC

Laboratory Demographics

  • CLIA Code: 15D2204244
  • Facility Name: GRACE ON WINGS, INC
  • Facility Address: 5128 EAST STOP 11 ROAD, SUITE 37
    INDIANAPOLIS, IN
    ZIP 46237
  • Facility Phone: 317 248-0910
  • Facility Type: Ambulance
  • Facility Type: Waiver
  • Lab Director: MICHAEL J. GAMBLE
  • NPI Number: 1700018132
  • Taxonomy: 3416A0800X - Ambulance

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CLIA Record

Field Name Field Value
CLIA Number 15D2204244
LAB Type Ambulance
Facility Name GRACE ON WINGS, INC
Street 5128 EAST STOP 11 ROAD, SUITE 37
City INDIANAPOLIS
State IN
ZIP 46237
Phone 317 248-0910
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 12/8/2024
Certificate Expiration Date 12/7/2026
Facility Type Ambulance
Lab Director MICHAEL J. GAMBLE

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