15D2216504 CLIA NUMBER - ACL HOME CARE LLC

Laboratory Demographics

  • CLIA Code: 15D2216504
  • Facility Name: ACL HOME CARE LLC
  • Facility Address: 1201 CENTRAL AVE SUITE 1 & 2A
    LAKE STATION, IN
    ZIP 46405
  • Facility Phone: 219 628-5672
  • Facility Type: Public Health Laboratories
  • Facility Type: Waiver
  • Lab Director: TERRIA M. CONWELL
  • NPI Number: 1699054080
  • Taxonomy: 253Z00000X - In Home Supportive Care

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CLIA Record

Field Name Field Value
CLIA Number 15D2216504
LAB Type Public Health Laboratories
Facility Name ACL HOME CARE LLC
Street 1201 CENTRAL AVE SUITE 1 & 2A
City LAKE STATION
State IN
ZIP 46405
Phone 219 628-5672
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/12/2025
Certificate Expiration Date 3/11/2027
Facility Type Public Health Laboratories
Lab Director TERRIA M. CONWELL

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