15D2241468 CLIA NUMBER - HEALTHCARE PORT LLC

Laboratory Demographics

  • CLIA Code: 15D2241468
  • Facility Name: HEALTHCARE PORT LLC
  • Facility Address: 720 W 5TH
    GARY, IN
    ZIP 46402
  • Facility Phone: 219 248-4912
  • Facility Type: Public Health Laboratories
  • Facility Type: Waiver
  • Lab Director: CARYSIA ROBERTS
  • NPI Number: 1831844539
  • Taxonomy: 246RP1900X - Technician, Pathology

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CLIA Record

Field Name Field Value
CLIA Number 15D2241468
LAB Type Public Health Laboratories
Facility Name HEALTHCARE PORT LLC
Street 720 W 5TH
City GARY
State IN
ZIP 46402
Phone 219 248-4912
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/28/2023
Certificate Expiration Date 10/27/2025
Facility Type Public Health Laboratories
Lab Director CARYSIA ROBERTS

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