15D2234233 CLIA NUMBER - DRAGONFLY PRIMARY CARE

Laboratory Demographics

  • CLIA Code: 15D2234233
  • Facility Name: DRAGONFLY PRIMARY CARE
  • Facility Address: 6835 E SOUTHPORT RD SUITE D
    INDIANAPOLIS, IN
    ZIP 46237
  • Facility Phone: 317 759-1843
  • Facility Type: Practitioner Other
  • Facility Type: Waiver
  • Lab Director: CRYSTAL D. WILES
  • NPI Number: 1033782156
  • Taxonomy: 363LF0000X - Nurse Practitioner

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CLIA Record

Field Name Field Value
CLIA Number 15D2234233
LAB Type Practitioner Other
Facility Name DRAGONFLY PRIMARY CARE
Street 6835 E SOUTHPORT RD SUITE D
City INDIANAPOLIS
State IN
ZIP 46237
Phone 317 759-1843
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/30/2025
Certificate Expiration Date 8/29/2027
Facility Type Practitioner Other
Lab Director CRYSTAL D. WILES

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