15D2218625 CLIA NUMBER - 219 HEALTH NETWORK

Laboratory Demographics

  • CLIA Code: 15D2218625
  • Facility Name: 219 HEALTH NETWORK
  • Facility Address: 9130 COLUMBIA AVE SUITE A
    MUNSTER, IN
    ZIP 46321
  • Facility Phone: 219 836-1310
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: TAREK KUDAIMI
  • NPI Number: 1013581123
  • Taxonomy: 261QF0400X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 15D2218625
LAB Type Physician Office
Facility Name 219 HEALTH NETWORK
Street 9130 COLUMBIA AVE SUITE A
City MUNSTER
State IN
ZIP 46321
Phone 219 836-1310
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/30/2025
Certificate Expiration Date 3/29/2027
Facility Type Physician Office
Lab Director TAREK KUDAIMI

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