15D2214426 CLIA NUMBER - VIDA ONCOLOGY LLC

Laboratory Demographics

  • CLIA Code: 15D2214426
  • Facility Name: VIDA ONCOLOGY LLC
  • Facility Address: 2150 INTELLIPLEX DRIVE, SUITE 134
    SHELBYVILLE, IN
    ZIP 46176
  • Facility Phone: 317 796-2200
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: JAIME AYON
  • NPI Number: 1659987832
  • Taxonomy: 207RH0003X - Internal Medicine

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CLIA Record

Field Name Field Value
CLIA Number 15D2214426
LAB Type Physician Office
Facility Name VIDA ONCOLOGY LLC
Street 2150 INTELLIPLEX DRIVE, SUITE 134
City SHELBYVILLE
State IN
ZIP 46176
Phone 317 796-2200
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 2/23/2025
Certificate Expiration Date 2/22/2027
Facility Type Physician Office
Lab Director JAIME AYON

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