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15D2216180 CLIA NUMBER - MICHIANA CONCIERGE FAMILY MEDICINE

Laboratory Demographics

CLIA Number: 15D2216180

Facility Name: MICHIANA CONCIERGE FAMILY MEDICINE

Facility Address:
1217 W PLYMOUTH STREET
BREMEN, IN
ZIP 46506
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Facility Phone Number: 574 546-0654

Facility Type: Physician Office

Certificate Type: Waiver
NPI Number: 1346958998

Taxonomy: 207Q00000X - Family Medicine
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.

CLIA Record

Field Name Field Value
CLIA Number 15D2216180
LAB Type Physician Office
Facility Name MICHIANA CONCIERGE FAMILY MEDICINE
Street 1217 W PLYMOUTH STREET
City BREMEN
State IN
ZIP 46506
Phone 574 546-0654
CertificateType 4
CertificateEffectiveDate 3/10/2023
CertificateExpirationDate 3/9/2025
FacilityType Waiver

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