15D2218625 CLIA NUMBER - 219 HEALTH NETWORK

Laboratory Demographics

CLIA Number: 15D2218625

Facility Name: 219 HEALTH NETWORK

Facility Address:
9130 COLUMBIA AVE SUITE A
MUNSTER, IN
ZIP 46321
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Facility Phone Number: 219 836-1310

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1013581123

Taxonomy: 261QF0400X - Clinic/Center

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
CertificateType	4
CertificateEffectiveDate	3/30/2023
CertificateExpirationDate	3/29/2025
FacilityType	Waiver

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